Homestead_CooperI
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDMSTANDARD DEDUCTION
S.bft Poem 5473 M? 15 M
Pnmaind by ft Depwirnent of Local Governam" l'inance FW DM
INSTRUCTIONS: See reverse side for Ring instructions.
�CERTIFICATM STWEKENT��,,--,,,
I (we) L 46 ow) cerfify
6 place of residenA the followng described real property for which a Horn is hereby dairned:
I (We) occupied as 'a
kkl I (M) owned 61&&Are buying under contract Zt:zW; tAUDITOR IMach' 20
Have a beneficial interest in the entity that is liable for the property taxes m the property and that owns the property or is buying under a contract
CONTRACT:RECOFtDED�':�'�,.+ „,,'��
tf buying on oo vb Fee Shroe owners name
Rmantees otboe where contract is recorded Record number Page
N .'PROPEFM
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Township
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the r the land riot exceeding one (1)
acre that mm y-
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rPROPEMT OWNED EWYCLAMWNT tWOTHIElt COL;Wnm� Wg&
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Township
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I hereby ce" the above statements are true. owed and complete.
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ASWSSOR USE ONLY. ' ,
VALUE
Lesser of 12 Homestead
A 4I ESWm cV 0 j A
Valuation or 535.000
OF
Date sqmd
Land not exceeding I (one) acre immediately
SM, if
surrounding residential innprovernents.
Other land
(2)
Tdal land (Im I jokis fire 2)
(3)
Dwelling
(4)
e- rIAMM-121A, v *!dl
'T N
Residential unprom. -ents or Annually
vt�, R.-
Assessed Mobile I Manufactuirod Home
Garage
(5)
Other arprovernents
(6)
Total knprovm nts (fine 4 Ovough Eno 6)
(7)
Tcted value (fine 3 plus fine 7)
1 (a)
I hereby certify the above is true, conrecL, and
signat" of ftsessa
Date ogee
Ven" actin - Somature of hdlg
Date 6wmd
20—Pay2O-
Lesser of 12 Homestead
Valuation or 535.000
Squature of kxftw
Date sqmd
,. " StATE FORM!"4.0C/1-1 IAFASURER FORMS IA
APPRIA'EO 11Y[r&TE MUD M AFtt11.TS.Vw PRESCRIBED BY Ow DEPMTR`rr(K LOCAL r VELMMFA'T FO&SCE IC•-1.1.1:4.1
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 ecer for homestead fraud.Homestead fmud causes higher tat hills for all:therefore.
HEA 1344-2000 requires anpaycrs who receive the homestead standard deduction to verify that they are eligible to reecho the
benefit anti to provide additional identifying information necrvan'to allow county government to better monitor honteseai
filings.This information will be kepi conlidential and can only he accessed by authorized county officials The Ikpanment of
Local Government Finance will use this information to create tools that will help county officials eliminate MRncstead fraud.
PART 1:PROPERTY INFORMATION
Taxpayer Name Property Address
Cooper, Peggy S 7//I 3 /8€S 13
2142 /
•
Peggy S Cooper
7112 S 1825 W State Parcel Number Legal Description
GRIFFIN IN 47616-9306
III I I I I I I au I I I I I I I I I I I I I 26-16-19-300-002.229-023 008-02229-00 PT SW 8 PT NW 19 3 13
n
r rite t 11 t t nn n t t t r 4.132 AC D-18
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
Owner I First Middle Last
tr e, Sue Cooper
®tog Address(number and street city,state,and ZIP code) ,Same as property address
—1-//2- S I92S co 6r;-FF,.t ..V cf-74,/(o •
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) l] Same as property address
Social Security Number(last 5 digits) I Drive's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
$6Y__ _ _
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 I Signature Date
)
PART 4:ADDITIONAL INFORMATION
al