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Homestead_Coats 6. 'fliE FORM!'5F iR=/W+, MEASURER FORM S:A DEPARTMENT OF!AXIAL OPERTY~OWNERS t A Gibson County Auditor 101 N Main 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(mud.Homestead(mud causes higher tan bills for all:therefore. ® HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the benefit and to provide additional identifying informaton neeessan'to allow county government to better monitor homestead Cilium.This information will he Lep confidential and can only be 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 1: PROPERTY INFORMATION Taxpayer Name Property Address Coats, Bradley F/Angela D • OAK \ FORT HRANCI I IN 4764Y 2942 • Bradley F Coats 500E Oak St State Parcel Number Legal Description FORT BRANCH IN 47648-1500 26-19-19-101-001.136-026 011-01136-00 PT NW 19 3 10.75 AC lrlullll llllll1 lllllllll nnll llrltllntiluell nrllunlelrl 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 ra d lte ��ar��< Coa 4-S ng Address(sum and street,city,state,and ZIP code) Some as property address —00 . Oak Si- &* 3roxdq , 1 N 4-7029 g Spouse First Middle Last R Beta rn C AS Mailing. ddress(Number and street,city,state,and ZIP code) Same as property address 500 E. ( .k 3-A- Fork- B ,h , jN /-1-7UoL{W - - • 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 .. liable for back taxes and substantial financial penalties. Owner I Si Date • °' CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEaR >. - > h CREDIT/STANDARD DEDUCTION HCio s��e F«m sa�a �rea r �-o» •� �.,s 1 Prescnbed by Ihe Department of Local Govemmant Finance INSTRUCTIONS: See reverse side for �ling insWctions. .,- �(WQ) � � O certiyry,(p���y1 o th st day of March, 20 I(VJe) occupied as our prindpal place of r ence the following scribed real property for which a Homestead Pm'pe�ty �t is hereby daimed: '� I(VJe) owned ❑ fve buying u r contract ��� �� Have a benefiaal interest in the enfiry Nal is liable fw the property tazes on the property and that owns fhe propGrty or is'bu�q�ng under a contrad. tl buying om m�trad, Fee Simple rnmefs nama office where conUad is recwded Tavnship T�ing district ¢el numbei Legal tlescnption I I a �-15'-�a-�d-t�ol.�3 -o� l� 1g-3;111' If arry portion of the residenUal aVUCWre w Ihe land no1 �ceeding one (1) acra ihel imrtcediately wrtounds oFihe property utiGzed In p�oduce income. Record number � Page q�,��: xea� wopeKr ❑ Moale Home (�c s-,.,-n �e is usetl lo pmduce income, descnbe Ihe use aM pOM1ion �_ � � � .� � � � i . • Land not exceedin9 t (one) acre immediatety ( � , � -' � _'t; ;. � surroundirg residential improvements. � ' - . Other land (p� - . ' Tdal land (line 1 plusline 2) �3) Dwellirg (4) ° ' { - ResidenGal imprwements w Mnually Assessed Mobile / AAanufachued Home - . - . - - Garege (5) � _ � . Other improvements (6) -- Tdal improvements (line 4 thiough line 6) ��� Tctal value (line 3 phsline n �g) I hereby terti(y Ne above is We, corrett, arxl Signature ofASSessor Date signed (mmtti, day, yea� complete. Verifying acUon - SignaWre of lwditor py(a signed (mmN, tlay. yea� 2� pay 20 _ 45,000 for 2007 pay 2008 42,000 for 207 0 pay 2017 Lesser of 1R qq 000 for 2008 pay 2009 41,000 for 2017 pay 2012 Homestead Valuaqon $ w ^ 43,000 for 2009 pay 2010 40,000 payabie after 2072