Homestead_Cowling SIMI RAM 5;9+,R3,'.lb 1R ASUKLA FORM n-IA
.PPtlT En iw CME noncom sm.NTS.rim N rMLYAnfrD HI lift DVAR1.MLT OF LOCAL COVER nSt ILw,cr 'b::X4..1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 It Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of:his deduction becomes
- Princeton, IN 47670 more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher us bills for ell:therefor.
' \ HEA 1341-209 requires taspavers who recede the homestead standard deduction to verify that they ate eligible to recede the
�I benefit and to pros idc additional identifying information necessary to allow county government to better monitor borecaend
111 filinu.This information will be kept confidential and can only be at-missed by authorized county officials.The Department of
Local Government Finance will use this information to mate tool;that will help county official,eliminate homestead fraud.
JUL 10 2012 PART 1: PROPERTY INFORMATION
Taxpayer Name Location Address
--- --C. :N\ -- —�— -Cowling,-Dennis'L• - - — -
GIBSON COUNTY AUDITOR 1563 E 1025 S
HAUBSTADT IN 47639
8355
Dennis L Cowling II 10111.0111 DI I I IIII_I CI VIII .I II I 1 011111_III II I VIII II till I��II011. tits i II
1563E 1025 S
HAUBSTADT IN 47639-8026
IIIIIIIIItItIlDllin. ii,. u .n ii'lltrIllii,,, rlttPll'llIl' State Parcel Number Legal Description
26-19-32-101-000.218-024 ELPERS SUB DIV 1 PT SW
SE 32 3 10.33 AC D-9
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-
: nerl First Middle -..._ _----.___..-_. -. Last
---
tA-,J,I s A. �,,17�
Mailing Address(number and street,city.state.and ZIP code) as property address
7n3r , 70x3-5: alley ¢DT //V 'cI. 3f
`
Spouse: First Middle Last
Mailing Address(Number and street,city,slate,and ZIP code) O Same as properly address .
Social Security Number(last 5 digits) Driver's License/State ID N umber (las:5 digits) Other(please specify in Pan 4 below)
- I State
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
unlawfu , he or she m ay be liable for back taxes and substantial financial penalties. _. - - -
Owtte/ .cure Date
��'� "°- CLAIM FOR HOMESTEAD PROPERTY TAX
'4 CREDIT/STANDARD DEDUCTION •
�� ���' State Fortn Sa73 (R2 / S92) �
���� '
INSTRUCTIONS: See reverse side (oi (iling instructions.
YEAR
� -T ��
JUN 12000
� CERTIFICATION STATEMENT
I(�1J ^ ^ QBifilqA}i� I 1st�day�ofnMarch, 19_
I(We) occupied as our principal ce of residence the following described real property for which a Ho siead Property Tax Credi[ is hereby claimed:
�(We) owned ❑ Are buying under contract . -
Have a neficial interest in the entiry that is liable for the property tazes on the property and that owns the property or is buying under a contract.
CONTRACTRECORDED �
If buying on contract, Fee Simple owners name
Recortlels office where ract is recorded Recortl number � Page
PROPERTY DESCRIPTION
County Township Taring Aistrict (ciry, town, township)
Parcel number Legal tlescription
p �1-- b o -- .
If any ponion of ihe residential structure or ine IaM not exceetling one (1) qo�e Nat immedmtey surtounds ihat svucture is used to produce income, descAhe Ne use antl ponion of
the Property utilized to P��e income. `�'�— � d4 3� ��-Z �
��� �� la �_��
- � -
- ' PROPERTY OWNED BY CLAI ANT IN OTHER COUNTRIES
Counry � TownsNp Counry Township
Signature dai ant
�:reby certify the above statements are We, correct and complete.
Adtlress (numBbe� and street, ciry. siare, ZIP code) _
/� �� H
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(oneJ acre immediatety
surrounding residential improvements. (�) �'
Otherland (2)
Total land (line 7 plus line 2J (3)
Dwelling (4)
Residential improvements
Garage (5)
Other improvements (6)
Total improvemenis (line 4 through line 6) (7) .
Total value (line 3 plus line 7) (8)
I hereby Certify Ihe above is irue, wrrect, and Signamre of Assesor Date signed
complete.
Verih�ing action - Synature of Auditor Date signed
� STANDARD DEDUCTION ALLOWANCE
19_ Pay 79 _ .
Lesser of 7/2 Homestead �
Valuation or 52,000
Signamre of Autlitor � Date signed
� ^ ^Q