Homestead_Fox _- ■
5l31E FORM!)MIR:l,t'q TREistJm FORM 75-IA
AFOOT ED BY',TAIL IXUPDtri An-TESTA mN PRESCRIBED BY nIE DEPARfO:n OF LOCAL CO ER:Pala MQ:ANCE IC LI.I-rsi
'
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'Krause than eser for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
• HEA 1344--2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and to provide additional idendnnne information necessary.to allow county government to better monitor homestead
filing..This information will he kepi confidential and can only he accessed by authorized county olfcials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
•
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Fox,William D/Idonna A 5 (SG S e 5f,P3 57
Po Hox 322
Somerville IN 47683
8439
William D/Idonna A Fox
Po Box 322 State Parcel Number Legal Description
Somerville IN 47683-0322
Illnlll nitllnlu lullll ll Ilntltlnlrll tltlu ltlnt'll 26-20-02-401-000.214-001 �D1-00214-00 PT NW SE 239.51 AC
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
/1it ( I1avv. Dd Fo x
tae Address(number and street.city,state,and ZIP code) - — -- Some as propem address —--
!PU Box 3aa1 ol� e( uit(e _Lv 47 S3
Spouse First Middle Last
_ 1 c46t�/nc` 4 , Fox
Mailing.Address(Number and street,city,state,and ZIP code) ❑ Same as property address
pO Box 3aa 5 Ovine r \h IIt sly i 76 3
•
Each undersigned certifies,under penalty of perjury,that the above and foregoing infonnation 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 Sign i are Date
so
•
t
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
} CREDIT /STANDARD DEDUCTION HC10
State Form 5.473 (R6/4-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) _ICY /�( 1/ 4 1» M1 ia�� certify that on the 1st day of March, 20_
I (We) occupied as our principal place of residence the follrriving described real property for which a Homestead Property Tax Credit is hereby daimed:
❑ I (We) owned ❑ Are buying under contract
rkHave 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.
'CONTRACTRECORDED
- �"' �-- ti'��5>: - ;� -ss>• ^'nom
If buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
_ ,.�, :�c�. + r�. u�.•.'
s�. �...-:• �; it.- �a. P, ROP, ERTY:DESCRIPTION"@.'n,�;�`..�.
County
Tavnship
I hereby certify the above statements are true, correct and complete.
Taxing district (dry, town, township)
m//b��e/rr��
a I — 0
Legal descrip tion
ic..VALUE
Is the property in question:
W
❑ Real property ❑ Mobile Home ( /.C. 6- r'.1 -7)
fParml
rt of the residential s e or the land not exceeding one (1) acre that immediat elyy Sy T ounds that s W Cure is used to produce income, describe the use and portion
p utilized to pr _Q _ / '." _ • �/_ /'��
surrounding residential improvements.
(1)
Y 1
3?�i'`���s*z-+�s -- �'t -FPR
P.ERTY,OWNED`..BYCLAIMANTIN OTHER' COUNTIES, ��a, �; .',� =�;1�'%�?r��s_.ret�•,,'�4, ��'}
County Township
County Tavnship
I hereby certify the above statements are true, correct and complete.
Signature of claimant
Address (number and street, city, state, ZIP code)
rr •es.s ±. i ii - mss?,
;YASSESSDR�U� SE ONLY
y '°w'
TRUE TAX""r 3''r>p
'.,UI
ASSESSED VALUE
.sHOMESTEADr'
_ "
' NON?RESIDEN- ri
valuation or 535.000
�YAI:UE.``3;�.�',..AT�100
%�
ic..VALUE
A� ML *VALUEaa ",?'
Land not exceeding 1 (one) acre immediately
"' D ` _ t3 �;
�'
surrounding residential improvements.
(1)
U""° }h-w��s�
Other land
(2)
.r`.r f
Total land (fine 1 plus line 2)
(3)
�.. ,i
Dwelling
(4)
'`.
Residential Improvements or Annually
Assessed Motile
e / Manufactured Home
Garage
9
5
()
x9ijmq
Other improvements
4C- '- 1'k'r.�xzy
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(g)
I hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
v
ms's'= STANDARD. DEDUCTION' ALLOWANCE•,. ?C,.„ tp,u '-q 4^"e > + :$S': .A
20 _ Pay 20 _
Lesser of V2 Homestead
valuation or 535.000
$
Signature of Auditor
Dale signed