HomeMy WebLinkAboutHomestead_Cox (2) • STATE FORM 5ar.0ZtS'} tRFAS1iRCR POR411A
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APPROVED RLwHPDnr An"AWES.2Dn PAFYTIBEm BY nit DEPARTRYT F LOCAL IXHrRYMnsTrncANCEMN.1-_ul
Gibson-County
.N.Main Auditor
11IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standani deduction.As the receipt of this deduction ha..nes
more beneficial.there is more incentive than nu for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
ILEA 1344-200c requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receise the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.'Ibis information will be kept confidential and ran only he accessed by authori,ed county officials.The Depanment 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 Properly Address
Cox,Anthony D/Diana C
R2 Box 117 A Q
Fort Branch IN 47648
8693
Anthony D/Diana C Cox
5912 E Sr 168 State Parcel Number Legal Description
Fort Branch IN 47648
26-20-18-100-001.830-001 001-01830-00 PT SE NW 18 3 9 2.10 AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Co x
Sag Address(number and street,city,state,and ZIP code) — - ' -- -'Some ds property address - - ----
.
SpousT Last
Middle �- - ! st
Mailing Address(Number and street,city,state,and ZIP code) aStne as property address
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 alio understands that,by claiming additional homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I Sgnatur Date
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
r' State Form 5473 (R215 -92)
INSTRUCTIONS: See reverse side for filing instructions.
F&6 YEAR
CERTIFICATION STATEMENT
�].
1 (We) .C.J rtify th
h 1 f
I (We) occupied as our principal pl of residence the following described real property for which a Home
�do,16025i laimed:
GIB
❑ 1 (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 owners name
'
Recorder's office where contract is recorded
Record number -
Page
PROPERTY DESCRIPTION
County
Township
Taxing distnct (city, town, township)
Parcel number
o - 3a
Legal description
ti �J g 3- to
II arty portion of the residential stricture 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 Dropeny utilized to produce income.
p - cei 23o - oo i
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
C, unty
I-
Township
County
Township
Signatu a of da t
eby certify the above statements are true, correct and complete.
Ad ss (number and street, city, state, ZIP code)
n
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
(1)
surrounding residential improvements.
Other land
(2)
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assesor
Date signed
complete.
verifying action .Signature of Auditor
Date signed
®' STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead S
Valuation or $2,000
Signature of Auditor
�9 / - ` ,