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Homestead_McCullough War lORN!!V*I R'OAK/ ,ro En BY MATE lNOOf✓�aM(_M1 r IFAUIU FORM 13-IA : A t m ET FINANCE MVI.1-LAI 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 e'er for homestead fraud.I Iomestead fraud causes higher tax bills for all:therefore. • HEA 1344--3009 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 filinrei.This information will he kept conldemial and can only he accessed by authorised county officials.The Dcpannsent of Local Government Finance n ill use this information to create tools that will help county officials eliminate homestead fraud. PART I: PROPERTY INFORMATION Taxpayer Name Property Address McCullough, John K/Tanyar 6- R I . . Oakland sty IN 47660 4328 John K McCullough 10653E 125 S State Parcel Number Legal Description OAKLAND CITY IN 47660-8639 26-13-13-300-001.042-006 003-01042-00 PT SW 132-91.21 AC C-t X PART 2:TAXPAYER INFORMATIOtN - Owner I First Middle Last John ke McCuJloucl g A d d r e s s(number and street city,state,and ZIP code) - 'S a m e as property h d d i c s c J — --- - - -- — 0 5 3 e Lass S DOLLla ,i C' -47 IA) '74; e0 Spouse First Middle Last 1a nL/a_ 7en�e Met Cu (�cruy h Mailing Address(Number and street city,state,and ZIP code) . El Same as property address I(7t75�' C in S 19tOand CI + "i Zlv Ch(ol00 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. (NIrer I Sicnaure Uatc • CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR CREDIT/STANDARD DEDUCTION HC10 State Form 5473 (R614-03) Prescribed by the Department of Local Government Finance INSTRUCTIONS: See reverse side for filing insinictions. e fif that o�he 1st of March. 20_ (we) as as our principal place of re!sidenc�e �afollonvmg dos d real property for Lh a! Homestead Property y Tax Credit is hereby claimed: ❑ a) o ad ❑ 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. ONTRACT�RECORDED�-�-'-,-'-'-� 11 bUylng on contract. Fee Simple owners name Recorders office where contract is recorded Record number Page 60 Vv$�� - - `IJMRIP.TIOWVj�;Z� :� .'t � t--- :- �'-*-WiPkOPERTY County Township Tani district (city, to", township) Parcel number () _ U Legal description 1 Is the! W��Ymqe�-tion 1 .3 0 4 a - (20 (VReal property ❑Mobile Homo (I.C. 61. 1-7) If any portion of the residential structure or the land not exceeding one (1) acre that immediately wmaunds that structure is used to produce income, describe the use and portion of the property ufitizM to produce income. te� - Al -/3 - d6r.) .� ASSESSOR USE ONLY County Township County —P-- nship I hereby certify the above statements are true, correct and complete. Signature of claimant Address (number and street, city, state, ZIP code) .� ASSESSOR USE ONLY TUETA�Xlf� ASSESSED -'-VaLjE 'd 2AH0ME*'S`T--ED' x �NONMIDENTAt Mt4a W §YALUE� & :�AT I 00%F - Land not exceeding 1 (one) acre immediately surrounding residential Improvements. Other land (2) M Total land (fine I plus line 2) (3) Dwelling (4) Residential improvements or Annually Assessed Mobile I Manufactured Home Garage (5) - si MEW Other improvements (6) 4� W11, Total improvements (fine 4 through line 6) (7) Total value (fine 3 plus line 7) (8) I hereby certify the above is true, correct. and Signature of Assessor Date signed complete. Verifying action - Signature of Auditor Date signed 20 _ Pay 20_ Lesser of 112 Homestead Valuation or S35000 =t77 _ In 3