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ArrWWED BY STATE BMWOf M rv•:ht ant PREXYUmmBr nu Dr?ARnfl 4TIf LOCAL tMCRVMrn'r re:A\CE IC•-I.1_rI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
- PRINCETON IN 47670 IndividuaLs and married couple.,are limited to one homestead standard deduction.As the receipt of this deduction becomes
— more beneficial.there is more incentive than ner for homestead fraud.Homestead fraud causes higher in hills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recehc the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings_This information will be kept confidential and can only he accessed by authorised county officials.The Department of
Local Government Finance will use this information to create avb that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
•
Couch. Clyde/Doris Rae Trust
>Box 148 —5
r122
Princeton IN 47670
4087
Couch Clyde/Doris Rae Trust
days ..5! r— State Parcel Number Legal Description
Princeton IN 47670-8804
�tlnllu l�rllnln rllintlnitln ltliuulu irlllni�t ttltitl 26-12-26-100-000.098-004 002-00098-00 PT NW 26-2-103.55 AC
v/ D-10
PART 2:TAXPAYER INFORMATION
Owner 1 d 1 / 2 m d O,.f 6th i , Middle Last
a vi/ rZ d074 h c Laugh . J }-u sI
—-
Social Security Number(last 5 digits) . Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
a:3G7--' 9`33 53 g .
Spouse First Middle Last
Dar/ s g coy e.
Mailing Address(Number and street,city,state,and ZIP code) Q Same as property address
- ? .4-- 6 S Sts l=
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
i
CLAIM FOR HOMESTEAD PROPERTY TAX CHEUIT FOR YEAR 19 -81L
SEE BACK FOR FILING INSTRUCTIONS V
I, (We) • °( �(u �i' _ ._ .... _ , cr.ilily I11:11 rnr Ihq 1st day of
®March, 19 -W, I, (We) occupied as our principal place of residence the following described real property lur
hich a�Ho�mestead Properly Tax Credit is hereby being claimed:
IS?
I, (We) owned .
❑ are buying under contract
❑ have a beneficial interest in jhe t_ axpayer
Property Description in n1L n�>�`'� County Township
Taxing District (City, Town, Township): o
Parcel Number or legal description shown on lax statement:
�._.� a� -� -moo - -- 9b•�f5rlc,
If buying on contract: Owners name (fee simple owned
Contract recorded in Recorders Office - Record
e
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
-ooh -- —
Any other counties in which individual owns or is buying real properly: County
I hereby certify the above statement is true, correct and complete-
SUee1
Township
Individual either owns or is buying under a contract that provides he is to pttl %� projiertyntaxes
on the residence, or has a beneficial interest in the taxpayer.
JUG! 2
FOR ASSESSOR'S USE ONLY -
True Cash
Value
Land not exceeding 1 (one) acre immediately
.surrounding residential improvements (1) _ a X00
Other Land (2)
Total Land (3)
Residential Improvements Dwelling
(4) 73 o o
Garage (5)
Total (6) — a -
Other Improvements (7)
Tr Improvements - Line (6) plus (7) equals (8) (8)
I , -,:eby certify the above is true, correct, and complete.
S,goamre of Assessor - -- --
nACTION BY AUDITOR -
e
AUDITOR `'
Assessed Homestead
Valuation Valuation
13o 930
/3%0o
1_'q__9_ 3_0
3 X70=
11:111. 7a3 -81
All