Homestead_Koonce Stilt. ■ FORM'O R` ' 't MEMOIR HAM 75-1A' Arrtms'EO BY'rMTE DakRD Or 1.1MU%lt.]/n psrsN amaYnIrorl•ARr\RYrrF LOCAL r,vaFNMrn-r FNANCE ICLI.t-tU-..I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than eser for homestead fraud.Homestead fraud causes higher in bills for all:therefore.
0 HEA 1341-3009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive a the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filing-.This information will he kepi cnnlidential and can only he accessed by authorised corny officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART-I: PROPERTY INFORMATION
Taxpayer Name Property Address
Koonce, William R III
414 li OAK
Princeton IN 47670
2680
William R Koonce III
414E Oak St State Parcel Number Legal Description
PRINCETON IN 47670-1614
lllmmllmmmllllllltmmlll lltll llllllllllllllllllilll 26-12-07-201-003.754-028 01&03754-00WARNOCK I3 PT
I
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
AI LLiftivl % Russ 6LL Koonce
5 Add:._s(number and-vote,city,s•,atc,and ZIP code)— — - - - - - — Kai ante as property address
'iv-) e . oh K S71' t tor I-0c iv ,rN ,i/7ro7o
Spouse First Middle Last
•
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
same
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjuy,that the above and foregoing information is true and correct and that he or she is eligible to
receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I Signature Date
0
: �(�F O
�
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION �
Siate Fortn 5473 (R2 / S92)
INSTRUCTIDNS: See reverse side lor liling instructions.
FORM
HC10
YEAR
CERTIFICATION STATEMENT �
I(We) A t1'�yt�on� [ 1 d of rch, 79_
I(We) occupied as our principal place of residence the following described real property for which a Hom d�op�'ty i,a� r it he by claimed:
�J
❑ I(We) owned ❑ Are buying under contract
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the {��ty or � b�� under a contract.
//
CONTRACTRECORDED
If buying on contract, Fee Simple owners name
GIBSON COUNTY AUDITOR
Recorders office where conVact is recordetl Recortl number Page
PROPERTY DESCRIPTION
Coun Township Ta�cing disinci (d to , wnship) �
Parcel number ,/^ Legal descnption
� ��� iv�
If any ponion oi Ne residential struccure or Ihe land froi exceeding one (1) aue ihat immetliatety surtounds thai sWCture rs used to protluce income, tlescribe ihe use arW ponion of
Ne properry utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township Counry Township
Signa�e o dai t �—
ereby certify the above statements are true, correct and complete. I �
Addre�s (purpberandsfre� ry, state. ZIP e) ' � -
4/ c- D� S� • r
ASSESSOR USE ONLY � TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE .
Land not exceeding 7(one) acre immediatety (�)
sunounding residential improvements.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4)
Residential improvemenis
Garage . (5)
Other improvemenis (6)
Total improvements (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify Ihe above is true, conec4 and Signawre o1 Assewr � Da�e signed
complete.
Veritying action - Signature of Autlitor Date signeA
� STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead r�
Valuation or 52,000
Si naWr o udiror Datesi ned
9 ��-�D/= �/