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Homestead_Crooks STATE FOtM 5.1,•11U 1v0 1 nrASt1AfR MAN TS-IA APPROVED BY ST CIE aMPO Or Arr.m..TS.1IN PRIS Rrymsy THE DEPARTMENT OF LOCAL CASs_LVMFM FINANCE tes-u-U-S.I Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTI=OWNERS PRINCETON IN 47670 Individuals and married couples are limited to one homestead sianda l deduction.As the receipt of this deduction becomes more beneficial,there is more incentive than eser for homestead fraud Homestead fraud causes higher tax bills for all:therefore. • HEA 1344-3009 requires taxpa)ers who receive the homestead standard deduction to verify that they are eligible to receive the benefit and to provide additional identifvine information necessary to allow count'government to better monitor homestead filing..This information will he kepi confidential and can only be accessed by authorized count'officials.The Depanntent of Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud. PART 1: PROPERTY LNFORMATION Taxpayer Name Property Address Crooks, Larry D/Shirley A 201 F South Fort Branch IN 47648 754 Larry D/Shirley A Crooks 201 E South State Parcel Number Legal Description Fort Branch IN 47648-1755 11111111 26-19-19-103-000.137-026/LOW SACADD1 PT NW 193 10.04 PART 2:TAXPAYER INFORMATION Owner I Fits! Middle Last LarYt >a cleoa .s - - -g.Address(number andstreet,city,state,and ZIP code)- - - - -- —' -Same-as-property address-- --- -- Spouse First Middle Last h 1-L 6r0 0Ks Mailing Address(Number and street,ciy,state,and ZIP code) Er Same 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 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 warn nc m iem ReuriDeO By Sute BoarE ol Ta+ Cammissioners To & FiIM in DuO��te CLAIM FOR HOMESTEAU PROPERTY TAX CflEDIT FOR YEAR 191� SEE BACK FOR FILING INSTRUCTIONS `�� C�.� �,4.4�_ „��-.� �eC�,�:.�,_ 2 . We) certify that on the 1st day of ��arch, 19� I, (We) occupied a� incipal place of resid ce the following described real property for which a Homestead Property Tax Credit is hereby being claimed: I, (We) O owned a�l� �Q/ 3� �Q ❑ are buying under contract ❑ have a beneficial inte�re/st in the taxpayer �/ Property Description in aCL t�i.a,n.i County �^�-�'�- Township Taxing District (.CiLy—Town,�ewnship): �O�- 'a'�'`""`''�-� Parcel Number _ or legal description shown on tax statement: ,,c.. o-zu-e.o .�� i � . S �z �tluJ ��f / 9-.� -io . o fc If buying on contract: Owners name �� simple ow�e.i �T/�/GJ �/y / 9-3'/D ��y Contract recorded in Recorders Office - Record No. Page If any portion of the residential structure 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 property utilized to produce income Any other counties in which individual owns or is buying real property: �hereby certify the above statement is true, correct and complete. �� . . � /�. ��, :.Q 0.°D_., n, .�,1 �_;� 9_ stree� Naaress County s�e�e Township Caae ' Individual either owns or is buying under a contract that provides he is to pay the property taxes on the residence, or has a beneficial interest in the taxpayer. - FOR ASSESSOR'S USE ONLY - Land not exceeding 1(one) acre immediately surrounding residential improvements Other Land �@ � � � � Total Land �� Residential Improvements�, � i979 �� /i" . �/6(�c.C'� Other Improvemenls�� AUDITOR Dwelling Garage Total Tr• '-Improvements - Line (6) plus (7) equals (8) I�.iy certify the above is true. correct. and complete. Siqnawre ot nsseswr � True Cash Assessed Homestead Value Valuation Valuation (1) lo �%o c: (2) (g) � `�O''' (4) � (5) �'�� " // . .n '� �jjjjjj/�jjj �_-�' i � �jjjjj�jj/� �jjj/�j� jjjjjj�/�j � �r: �%%%%�%°% %%�'%'/','° �iiai�,/.�/ ; //aii . � � � ' • _ � _ �� jj/jjj/�/ -- + " - ��/��/ . � l s3 i � ti9 Dare � Date: