Homestead_Cox (3) •
•
TRFYSUa[a FORM FORM'" 1 1HMI
APPRIW ED Ire NMRD OFNYYAL%Il.Y•N PIS SCRIBED BY nIr DEPARn2Vr .(LOCAL GOVERNMENT EPA\'CE IC4-1.1-24I
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.Ilomesread 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 receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kept cnnlidemial and can only he accessed by authorized county officials.The Depanntolt of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Cox, James B/
RI}
• V .\! .YFS`IN
4298
James B Cox
10957E Base Rd State Parcel Number Lezal Description
OAKLAND CITY IN 47660-8468
26-13-12-300-001.455-006 003-01455-00 PTS 12-2-91.021 AC
x -
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
X4PIES Bract/ C'o/
ling Address(number and stmt,city,state,and ZIP code) �p — --L�'eme as properly oddh¢ — - -" - -- —
/0957 e 5 f 84 Se /1 oo r/
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 I Signat • Date
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5.473 (R6/4-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for Filing insimclions.
W� FORM YEAR
HC10
e) �' certify that on the 1st day orf March, 20 n
occu i d as our principal place of residence the following real property for which a Homestead�Property Tar - Credi--Z) hereby�daimed:
f Lli�ui -viYV/ r hereby
I (We) o d ❑ Are buying under contract G'1S�'•' ']-I "'v
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 under a contract.
�"—.w .c'"3r:. a.. - t_ ..•, .a?CO_NTRACTREC_ORDEO - • '.`w +'T-?, 3x2^r -t . ' sa .'' �'f,` �,.�:,°` � v
If buying on contract, Fee Simple owner's name
Recerdees office where contract is recorded Record number Page
"-' err" t•" rs.s`.W?"s`it,`eKT- �i- aa_s'._ -. .PROPERT,Y.DESCRIPTION.
County
Township
Taxing d'
c (city, to , township)
Parcel number
50 3 40
VALUE
`ia.._ _..
ri5
Is the propey in q stion
—
rty Mobile Homo (I.C. 61.1 -7)
aprop: e
If any portion of the residential structure or the land not exceeding one (1) acre that immediately
surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income. I O Q 1
c4LIO - I& to - O SS -- X4l
Other land
e
County Township
County Township
I hereby certify the above statements are true, correct and complete.
Sig of cla nt
Tess (number and street, city, state, ZIP coda)
5i _ va','+.s "=i C7:�` x. ` ��Ti
' a- tP�, _
ASS ESSOR�USE ONLYy "
a.�^s.e -.v `y.
° TRUETAX v
-J t`�_ �-
...v
ASSESSED VALUE
KATx100Ye.OFTTVz
q Asa..+. -r Y-
ssHOMESTEAD
ry+�••
s.hiNON- RESIDENTUIL - -?
- Ilse''VALUE'_ 5!1
rWy-
?F :i '3 , el:tT'- .�dla3eh�.JteCGS.'Se�£�.
VALUE
`ia.._ _..
>..a.�.. >..�..
V_ALUE�
.,.
C -+G... - .:.Y3..,�_
Land not exceeding 1 (one) acre immediately
4-�
surrounding residential improvements.
Other land
}
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residenfial improvements or Annually
Assessed Mobile / Manufactured Horne
Garage
_
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Trial value (fine 3 plus line 7)
(6)
1 hereby certify the above is true, correct, and
Signature or Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
1 ..,u s '.Syg�j?�SS;xc AL i't 3fia°FwSVZ'.� ifs +1xuT3�::"
zr'Or.a • afi. STANDARD:DEDUCTION LOWANCE?te$''�
20 _ Pay 20
Lesser of 1r2 Homestead
Vauaaon or $35.000
Signature of Auditor Date signed