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Homestead_Cooper r • STATE FORM MM in:/PWI TPFASUtEA FORM TS-IA APPlinCED BY SLOE MSRDt*M[YtLTS.!n.M PRE9(FID[D BY WE DEPART cNT OF LOCAL CASrLMMETT FWA%CE IC 4t1"41 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 es er for homestead fraud.Homestead fraud causes higher tax bills for all;therefore. HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to teethe the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of Local Government Finance will use this information to create wads that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Property Address Cooper, Dallas R/ Beulah L 1444 S SR 57 Oakland City IN 47660 193 Dallas R/ Beulah L Cooper 1444SSR57 Oakland City IN 47660 State Parcel Number Legal Description 26-13-24-100-000.188-006 003-00188-00 PT NE NW 24 2 9 4.751 AC C-1 -- - - - - - — _ - - - - - - - __ PART 2:TAXPAYER INFORMATION Owner I First Middle Last CiTJ c, Ll a_ Rfa. ����M�Jt;e �tg Address(number and street,city,sate,and ZIP cede)- y -"- - U Same as property ad V • ILI!-{ 1' S- 5-C. RA. • 5 7 Cad 0_ v■,p1 C1--1/4-�1,T� I q7/91,0 Spouse First Middle Last C Mailing Address(Number and street,city,state,and ZIP code) ly0 l Same as propert • dress "..-- PART 3:CERTIFICATION 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 Signature Date C i M °? , CLAIM FOR HOMESTEAD PROPERTY TAX FORM e CREDIT /STANDARD DEDUCTION HC10 State Form 5473 (R2/1 -90) INSTRUCTIONS: See reverse side for filing instructions. CERTIFICATION STATEMENT ✓ YEAR I (We) _If ITA j I�C �' "cdrtify that on the 1st day of March , 19 9� IfWe) occupied as our principal place of residence the f ollowing described real property for which a Homestead Property Tax Credit is heieby claimed: 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 property or is buying it under a contract.- VTT I9T*k� CONTRACT RECORDED If buying on contract. Fee Simple Owner's Name Recorder's office where contract is recorded Record Numbe� 4�rO Ali0 PROPERTY DESCRIPTION County. Town Taxing District (City,,town, township) Parcel Number Legal D c iption - Nw a If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc- ture is used to produce income describe the use an.cl.portion of the property utilized to produce income. County PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES certify the above statements are true. correct and > (Street, n ber, city, state and ZIP de) l 6 /,> 4M, ASSESSOR USE ONLY ' TRUE TAX VALUE i 6 G HOMESTEAD VALUE NON - RESIDENTIAL VALUE Land not exceeding 1 (one) acre immediately surrounding residential improvements Otherland Total land - line (1) plus line (2) Residential improvements. Dwelling _ Garage Other improvements Total improvements - line (4) through line (6) Total value - line (3) plus line (7) (1) 1991 Pay 1992 Lesser of 112 Homestead Valuation or $1,500 19— Pay 19 Lesser of 112 Homestead Valuation or $1,500 (2) Signature of Audi r (3) (4) (5) (6) (7) (8) 1 hereby certify the above is true, correct, and complete Signature of Assesor Date Signed Verifying Action - Signature of Auditor Date Signed STANDARD DEDUCTION ALLOWANCE 1989 Pay 1990 Lesser of 1/2 Homestead Valuation or $2,500 1990 Pay 1991 Lesser of 112 Homestead Valuation or $2,000 1991 Pay 1992 Lesser of 112 Homestead Valuation or $1,500 19— Pay 19 Lesser of 112 Homestead Valuation or $1,500 Signature of Audi r Ra Sign M