Homestead_Lecloux STATE FORM.Wes'P:I NMI rtYASIUIER FORM 71-IA
APPROVED BT Sfllt bINO Or AT<UNTS.ran flSYRIBFD BY THE BEMRfeIT OF LOCAL r vEt'MrAT FINANCE R'1.1.1424.1
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 ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEX 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they am eligible to teethe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filing.This information will be kept confidential and can only be accessed by authorized county officials.The Depanment of
Local Govenunent Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Lecloux, James A/Rebecca L
Chapman (I
R2 Box 288
Princeton IN 37670
1125 OCm
James A LeCloux
C210-E Monroe State Parcel Number Legal Description
PRINCETON IN 47670-2410
Ir— IIII I I I 26-12-07-403-000.960-028 019-00960-00 WILLIAMS 2ND 11
rinllutl tllnlutlll Itlt a err III' tit n r
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
Owner I First /� Middle /1 Last
—Not riles A L2�L/IovX
srAddress(number and-street.city,state,and ZIP code) ® Same as property address
2 in X fenn.oe_ Ys74.
Spouse First Middle Last
It a L Le (?/acx
Mailing Address(Number and street,city,state,and ZIP code) ® Same as property address
2I0 F , , S.rJ . -51/7 70
--__._--�-- - - - --
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 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 ignature —L Date
4
CLAIM FOR HOMESTEAD PROPERTY TAX
- CREDIT/STANDARD DEDUCTION
t-- � State Fortn 5473 (RS / 70-07 )
��r PreStriDed Ihe De
by partrnen� W Local Govamment Finairce
INSTRUCTIONS: See reverse side /or filing instrucfions.
FORM
HC10
YEAR
��'^'e> ��YIIIY.�— /�/ y��(x!�-�r .c.J� 0�:.�C.IW c.CJW certiry mat on We tst p�y�f Mac�n�
I(We) occ ed as our principal place of residence ihe following described real pmperty tor which a Homestead Property Tac C�ift hareby d:
❑ I(We) wned ❑ Are buying under contract
i
� Hava a benefidal interest in the entiry that is liable for the property taxes on the property and that owns the pmperty or i5_buying und,er<a aonlracC<
It biry'vg on conVact. Fee Simple ownefs name
Remrdefs ofica where conVaq is recorded
Counry
Co�nty
7ovnship
idenUal aWCfure w theTand not
tu produce irrcome.
Twvnsnip
one ii l aae ihat
I hereby certify the above statements are W e, conect and complete.
sfreei,
Record numDer
T�ing tlisirict (dry, fown, fownship)
Page
I Is the property in question:
❑ Real Droperty ❑ Mobile Homo (I.C. 61.1-� .
wrrounds that sWCture is used W produce inoome, describe the use anE poNan
Couniy
�����°��`�F� � E}QN� • y�� �;�TRUETAX��� AS8ESSEDYJ1UlE �HOMESTE D r,.��NON1tESIDE�SL��
���n:iL.'Y4B"`�'_4���.±��+-. .`Y���t.uVALUEt``-�.� �AT�700%OF�TTV��VALUEf�� ����`iVALUE -"'-
Land not exceeding 1(one) aae immediatey - ��T'�`...,'�'-'� �� +?��X�-,�,�y
surtoundingresidenUalimprovemenLS. (�) ���.�„�������.�-�,,.,��
Other land �`� ��x �
�Z) t�ca.���'�
Tdal land (line 1 plus line 2) (3�
�.-�,.k ��.iy..� ��-.
Dwelling (4) '�A'�1�'�,s�'�'3'� `�^' �
Residential improvements �P�� i p��`� �
iE.'�..sk,a.`.+{c�S,si.�..,Ga. "'�it.!<.�
� �� � � x��,. �
(5) �..,
Ga2 e
9 e .� i t i+�'!' �i
r✓�„� c..-:.. � ���=s�
�'����
Other improvements (6) �T,�..
..z_� > Y. ,x�-� .r
Total improvemenis (line 4 fhrough line 6) (7�
Tdal value (line 3 pl's line n (g)
I hereby certify Ihe above is W e, coned, and Signature o( Assessor Date sgned
completa.
Vui(ying aqion - Signature oflwEimr Date si9ne0