Homestead_McCoy Malt.FORM!Me 1R:/fwl Rl.4Ntf 1010175-1&
.APPROVED BTSt 1L EIMW)oi MX PUNTS.!✓. PtIYMBWDY TIE DEPAAIWN7 rF LOCAL rAAF0.4MQ.7 fe::Nct M 1.1.1-r4.1 _
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.llomenead fraud causes higher tat bills for all:therefore.
® HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are elicible to receive the
benefit and to provide additional identtfyme information neceswy to allow county government to better monitor homestead
filing.This information will he kept confidential and can only be accessed by authorized county officials.The Depanntent 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
_ McCoy, Harold A/Glenda J
WILLOWBROOK DR
PRINCETON IN 47670
2378
Harold A McCoy
1515 Willowbrook Dr State Parcel Number Legal Description
PRINCETON IN 47670-3353
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NI 26-12-06-402-004.163-091
NORTHBROOK HILLS VI6
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PART 2: TAXPAYER INFORMATION
Owner I i
/� 77�� First Qn�j Middle meal/
Last
c Addrev(number and suui:city;store;ar)d ZIP code) - --- - --- — -- -Same as cpcny ad _ .- _ __
1515 Vl/) 0 z u) Q.aoK -k , ,I�- ./1 , '7767o
D
Spouse /..--°/ First Middle �� Last
(- /E )DA— 3 • `f/
Mailing Address(Number and street,city,state,and ZIP code) I ') p Same as property tdddress
/Sic- IAI 1I otv .00e-rpt / iN� A . 7� 7b
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.
Own I ignature 11 G Date/7/zolo.
"
• V
CLAIM FOR HOMESTEAD PROPERTYTAX
CREDIT/STANDARD DEDUCTION
� Fortn 5�73 (R7 � 5a8) �
RasabeC by 4ie Oepatrrianl d Loml GoYamart Frw�m
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