HomeMy WebLinkAboutHomestead_Koss STAIt FORM':!w Wt.-10i nu-ASUR[A MEW 15-1A ,•
APPROVED BY,Alt 3O\RPOF.V tOrNit.ri.u PRLNRnniO BY MW.IMPARTV6r OF LOCLLCOrtASlnSi.essMLMbt.I_`-n
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS'
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
Princeton, IN 47670 mots beneficial.there is more incentive than ter for homa4ad fraud.Homestead fraud causes'nigher Pas bills for all:therefore
IP
Illi,\ 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to nreive the
�� benefit and to ptsidc additional identifying information nccc ary to allow county government to better monitor homestead
filings.This information will be kept confide tial and can only be accessed by authorized county officials.The Department of
Loch Government Finance will use this information to crate tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
_ V
tica Taxpayer Name Location Address
VO Koss, Richard J/Pamela L It
�y 736E OAK ST
748 ? GO JN� iZO PRINCETON IN 47670
' II Illloll Ill IIIlIF II [IIIII III IlIl=1011111111 ll l 1110111111Ill
Kos s
836 E Oak St
PRINCETON IN 47670-1604
IIIIIIIIIIIIIIIIIIIII11.111111III1II1III111 1111I111111I1I111111I State Parcel Number Legal Description
26-12-07-202-004304-028 NS LOT 4PT R3
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2:TAXPAYER INFORMATION; •
.er I First Middle Last
gIdNARz f v KO55
Mailing Address(number and street.city,state,and ZIP code) 0 Same as properly address
836 /54-5T cAl< sir ifercrT fir iA-c6=TO.v , iw V767C
Spouse First Middle Last
•
PA iy el A L ICvSS
—Mailing Address(Number and street.city.state,and ZIP code)— _ _ — — _- Ill Same as property address '- _ __- _ _ -
- •
Each undersigned certifies,under penalty of perjury.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 properly.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
•
�
C1141N FOR HOMESTEAD PROPERTY TAX
CREDiTISTANDARD DEDUCTiOId
smte Fonn 5473 (R7 � sdbl
Aeacrbed by Uie Depatrnent of Laral Gouerm�er4 Frianm
INSTRUCTIONS: See ieversa side /or fil'vig e'strucLbns.
�
FORM --
HC70
�
i cwe) L7��=Gli-Q�1-4�' ���'�irnv�� �-�.e-�J� cersy n,ela� R,e ��i^� �a,�,. zo_
I(We) ocapied as ac pru�dpal of residence Me fo9owirg descnbed real property for whirh a Hornestrad Propaty T� Cre/d�t is hereby daimad:
'� I(We) owned ❑ Are buyug unda cantrect �"
Have a benefidal mferest m the entiy Viat is liade kx 9�e property mxes m the popaty and tivt ams the����� eAUaF�aaa
, . . -. . .. .• . . Cai7RACT:RECORDm " �i4;�h .i';:�` t "c• .:,�'.� i �v�:�g:
�rc a,y.g on �o-aa. r�e si��le o.ners narne
�s � �a �d � �� Recortl num6er Page
_ _: _
�. .. �_ . � � " � ..-. , .. � �.
Jr.
Canty TonshiP T� �(c!Y. fnrn. foMnsltiD) �
�� � `a°a"�°" �- � � 3 u � � � � ❑
Mad�e r�me p.c. �,.,-n
n ny portion mthe raside� strucave o n» ww nal m�maQrg w,e ) aoa nvl :�ne6�dy c,rtu:� mm �e is usea ro w�:�. des�xDe me �e ana pu6on
properry �aiimd m P��e rt�mme. ..
oZC9�/d-a7-2-od-.00�f-3o�f-o�b�
. ,. . : > ,..,. .. � � - , �
, .TfH1E TA7C ASSESSm VALUE HOO�S7EAD y NONitESmBiML ��
�,: �' ^ . rASSESSORU3EONLY . - � , ��. yp�VE;�... � �AT,100XOFTTV .:-. VALUE t .. ,. g�A'y':.:.VALUE� �:'u"��f �.�
�8fld f10� BJfCE8d11NJ 1(OIIB� HQC Iffvf18�18}Ely . . •• t� "��,� l�':it ��'�"` i r r r3� ��
s�mound'vg fesidential irt�proverr�ents. (7 ) ,�j �S r 1 �.,'w b xj�+� r1s 5� 4+,
�?t�- i h 3�r'r.%-d) &'�r��
�IBf �8fld �� �%,� �•h�'' �
(2) � ,: � �.,:f,,'
Td� land (I"me 1 pkfs f'me � lg)
a � r�
7si � �s s� �. t�ua��Y�
Resdential cnprovert�ents a Mrwafy ��� �4) �,� �' � ' �': r � i i �°3'�{T'Sn'�tc�?y�a;'�
AS.SBSSCd MOdIE/ M�U�B�II� ��Of118 � �) �. 1 ��a�yV�l'.4 it�tA^� t77� �iVl;�rJ4'y.
� 5 . _.x.,� �.. f . ��. h...Z;#t.na�1'..;,�Fi;;`�_
�:
Otl�ef "vnprovgr�enfs (6) 'S"
TRaI unprovemerAs (fe�e 4 Wough 6ne 6) (7)
Ti1al value (lure 3 pks 6ne n (g)
I hereby certity the above's true, ounect. and Se�� mwsa�smr Dam egied
mrnplete.
Vaihine a�tion - sgisuae orawmr Date �ied
� . � . . � . �� SUWDARD DEDUCTION /1LLOWNICE � .c.:.=:r .n''�: =iY . . <,n, � u.� �,r �c_tn
20 _ Pay 20 _
Lesser of 12 Homestead
Vahwtion or 53.5.000 E
Si�ahue af Audtv DaU signed