HomeMy WebLinkAboutHomestead_Cooper STATE FORM Meg(RS/B-10) TREASURER FORM is-IA
APPROVED BY STATE BOARD OF ACCOUNTS_2009 IRESCTnm9 ay ME DEPARTMENT OFUnLUnTR MENT FINANCE IC6-11-2141.l
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY ONYNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction As the receipt of this deduction becomes
Princeton,IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax hills for all;therefore,
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
I- 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 he accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Location Address
.. Cooper, Stephen K/
•
775 E
FRANCISCO IN 47649
1152 II
•Stephen K/ Cooper I IIDIGIII_DII1I1OII_GIl1011 Oi DIIl1BIllii_1111[tU111111011n1]I011_II_DIIOIIIiGil II ll
4293 N 775 E
Francisco IN 47649-9257
IIIIIIIIIIIIiIIIIIIIIIIIIIIIIIIIIIIIIuyIIIIIIIIIHIIIIIIIIIIII t Legal Description
2'R;O; 1 1tWsIII: 017 /PT NW 21192.070 AC
APR 14 UM r
GISSOU CIIIII f '
• This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2:TAXPAYER INFORMATION
_
_
Ow ler I First Middle Last
?-liPVCIPt1 ipl,Pnic 0 Cl( 1/4FC
Mailing Address(number and street,city,state,and ZIP code) E Same as property address
tiaot.3 1-fl E Fceine \moo F en . '-v-\to-k
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 ' ture Date
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDMSTANDARD DEDUCTION
State Form 5473 (R715-05)
Prescribed by the Depertrnard of Local Government Finance
INSTRUCTIONS: See reverse side for Ring instructions.
M YEAR
( V
10
I
v 'I LEr)
certifythaton& stdayof March,
I (We) occupied as oud principal place descrit6d real property for which a Homestead Property Tmr Lpner mad
) owned ❑ Am buying under contract GIBS �5
acre a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buy'ingG,unrdlery, GPOR
:qi.g-ti !CONTRACTRECORDED>',
if buying on contract Fee Simple owner's name
Recorder's office where contract M recorded Record number Page
Mc
County
County"
TaImstip
Taxing jlsu,,ct
(cify town hynship)
ftrod number
11s;
the ProPortY �RsW
•
Land not exceeding 1 (one) acre immediately
property Mobil. Home (LC. & 1. 1-7)
ff any structure or the land not exceeding ore (1) acre &of immediately surrounds is used to produce income, describe the use and portion
PT`-`O�P�"
of the Income.
0%0 20
surrounding residential improvements.
cfwl- 0 4 - J-/- /.f-0 - Lao 0 z/V 3G -o/%
STANDARD'DEDUC710NIALCOWANCE' ,rtt
20_Pay2O_
Lesser of 12 Homestead
Valuation or $35,000 $
sqlat,ffe of x4tor Date signed
County
Twnstup
Comfy
Township
I hereby certify the above statements are true, correct and complete.
sign' M of dam
� - - (numbW and stmei, dry; state, VP code) I
'W1 � AIV
STANDARD'DEDUC710NIALCOWANCE' ,rtt
20_Pay2O_
Lesser of 12 Homestead
Valuation or $35,000 $
sqlat,ffe of x4tor Date signed
Me-
",TRUE,TAX4
D
i MESTEAD--
V1.
A kOklk&131!11'
IMAM
•
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
Other land
(2)
Tinted land (1km I plus &a 2)
(3)
rig
(4)
r
n, P A
W OP
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Garage
r
eA-1%
(5)
M,
Other improvements
(6)
Trial improvements (fare 4 through One 6)
(7)
Total value (lure 3 john fine 7)
(8)
1 hereby certify the above is true. correct, and
Signature of Assessor
Date signed
complete.
VadywV action - Signature of Auditor
Date signed
STANDARD'DEDUC710NIALCOWANCE' ,rtt
20_Pay2O_
Lesser of 12 Homestead
Valuation or $35,000 $
sqlat,ffe of x4tor Date signed