Homestead_Crooks (3) .
1 HATE 10101,3!M IR'/!wl TREASURER FORM MIA
.APPRIT EDDY,T5TE DOOM OF AMCNs.9Y PRt_XtUam BY 711E orrAnnerr tw LOUT GOVERNMENT FP:.wcr IC l.142i1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead aandani deduction.As the receipt of this deduction becomes
se-
more beneficial,there is more incentive than nee for homestead fraud.Ilonrstead fraud causes higher tax bills for all:therefore.
HEA 1347-2009 requires taxpayers who receive the homestead standard deduction to seri&that they are eligible to raceme the
benefit and to provide additional identifying information necrssoy to allow county government to better monitor homestead
filings.this inhumation will he kept confidential and ran only he accessed by authorized county officials.The Depanment of
Local Government Finance will um this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Crooks, John F/Virginia R- Life Est
E
CR1150E
`' / Oakland City IN 47660
5618 /\lox/
John F Crooks
2072 S 1150E State Parcel Number LeEal Description
OAKLAND CITY IN 47660-7628
I EIn IIntlrllulllullr illtnitlluu'tllnlllntlnit 111111 26-14-19-300-001.485-006 PtNSW I 92-8 1.80 AC
X
PART 2: TAXPAYER INFORMATION
Owner First— / Middle Last
/ 7 °At) !- reckr .L' k (Nook s
IIITg Address(number and street,city,state,and ZIP code) Same>u property address -_ - _ - _-' '_
/
S a;/� First Middle Last
Yry,� ; n ; a ,o, -e � ° s
Mailing Addr (Number and street,cillyyy,stale.and ZIP code) �- ESame as property address
/21 - ad �L/y B-d_c
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.
Owner 1 Siensturc Date
•
ei ¢ CLAIM FOR HOMESTEAD PROPERTY TAX FORM
CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (R215 -92)
sie
INSTRUCTIONS: See reverse side for filing instructions. _
CERTIFICATION STATEMENT .
YEAR
I (We) certify that on the 1st day of March, 19
e) upied as our principal place of residence th ollowing described real property for which a Homestead Property Tax Credit is hereby claimed:
I (We) owned ❑ Are buying under contract
�6ave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or i uyinT, jerEf
CONTRACT RECORDED �•%
It buying on contract, Fee Simple owner's name
"0.
Recorder's office where contract is recorded Record number
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township I County ITownshile
JIM re Ify the above statements are true, correct and complete.
jjjj�ress (number and street cily, state. ZIP code) _
ASSESSOR USE ONLY
TRUE TAX
VALUE
PROPERTY DESCRIPTION
County
NON - RESIDENTIAL,
VALUE
Township
(1)
Taxing distri Kc y t
n, rownshi
Parcel number
Otherland
Legal description
Total land (line I plus line Z)
OOZ
Residential improvements
Dwelling
(4)
If any portion of the'rMsidential stmcture or the land not exceeding one (1) arse that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized
to produce income.
Garage
(5)
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township I County ITownshile
JIM re Ify the above statements are true, correct and complete.
jjjj�ress (number and street cily, state. ZIP code) _
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL,
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Otherland
(2)
Total land (line I plus line Z)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pbs line 7)
(g)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Wing action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 Pay 19_
Lesser of 112 Homestead
_
S
Valuation or S2,000 '
Signature of Auditor
Date sped-) T%
If