Homestead_Hook MATE FORM!!YNIR_/EO t tRUSWILR FORK ZIA
APPROVED KY Rnrt BOARD OF MYr*pTS.aw PRrgUBED BY mrnEPMTHENTOF LOCAL GOERNMEN7 FINANCE KH.I-r.A.t
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 M this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud.I lomestead fraud causes higher tat bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they ate eligible to receive the
benefit and to provide additional identifying information neccssaty to allow county government to better monitor homestead
filings.Ibis information will he Lard confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will we Ibis information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Hook, James H/Kayrol L
RI Box 181 B
Oakland City IN 376(4-'
4875
James H/Kayrol L Hook
4063 S 900E State Parcel Number Leal Description
Oakland City IN 47660-8401
litilunllnititl 26-13-34-3X00-000.059-006 003-00059-00 PT NE SW 34-2-92AC
PART 2:TAXPAYER INFORMATION •
Owner I First Middle Last
me"S if. _ 11-oo/c
•tg Address(number and street,city,state,and ZIP code) n Seine a.prmperay oddr¢; — - — —
c/oCk 3 S. coo.. O4Kcltsui) C 11y /it) q1&( o
Spouse First Middle Last
Ka.ye_4L Nit) ("Dot_
Mailing Address(Number and street.city.stale.and ZIP code) ❑ Same as property address
/-/G6 3 S. QwC. O7?Kc6'bwti) c r hf C776 60
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.
• I I Signature`/�J�/ Date
0
a./ CLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
State Form 5473 (R215 -92)
rus
INSTRUCTIONS: See reverse side for filing instructions.
•� .-FORM YEAR
JUL 2 51996
We _ TV 'Ci. p �_- _I�i�}Q'rC -1 certify that En the 1A�pI OW,, 19-Q
Sc ied as our principal place of re ence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
l�l (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 under a contract.
CONTRACT RECORDED -
It buying on contract, Fee Simple owner's name -
Recorder's office where contract is recorded Record number Page
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
PROPERTY DESCRIPTION
County ..
Towns h'
Taxin 'stet (city, t wn, township)
Parcel number
Oi)3 5q
L ascription
tJ . 3 - a - a:ao A c -
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.
Signature
Otherland
(2)
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
Township
®-eby certify the above statements are true, correct and complete.
Signat r of claimant G�OIL
Address (number and street. city. 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)
Valuation or S2,000
Signature
Otherland
(2)
Date signed p /
1 _ 1 y
Total land (line 1 plus line 2))
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
plete.
[thereby certify the above is true, correct, and
Signature of Assessor
Date signed
ying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
-
S
Valuation or S2,000
Signature
01 /mu ditor ',,�//
D. 1
Date signed p /
1 _ 1 y