Homestead_Tepool - (2) STATE FORM 3.1"6.11C/tar, IRFANFFR FORM CIA
.AMOVED nY CflTE WARD Of NYr.I%'rc,:ion PRISPIBIP BY ftf DEPART 4T OF aP'Al CAVEELNMEA'i FINANCE IC 4.1.1-12.1.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to err homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than net for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verity that they ate eligible to recene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.Tins information will he kept confidential and can only he accessed by authnrieed county officials.The Depanment 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
—. Tepool, Richard H/Peggy J
9989 5 450 W
Cvnthiana IN-17612
7155
Richard H/Peggy J Tepool
9989 S 450 W State Parcel Number Legal Description
Cynthiana IN 47612-8809
26-18-32-200-001.036-024 004-01036-00 PT NE 32311 .701 AC
II lIr lllttirll Il rll lllrtlllll ltlltl tlrlll111lrl rlrlll loll
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PART 2:TAXPAYER INFORMATION
Owner I y First /. Middle Last
f �1 A'1ap 11 ���y Coo
Ig Address(number and street,city,state,and ZIP code) !� ame as properly address --
-�T 17siS 4SOv1 `lei i/4&147 h '176i
Spouse First Middle Last
Peg-6 i 01)1C, '(r--1Po6I
Mailing Address(Number and street,city,stale.and ZIP code) 2--Same as property address
•
cm 895 it5 o wJ &/flt'1 m , 7✓Lf /z -
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.
Own I Signature Date
s`
FOflM HC IO 19i9
PreS[riDea By S�aie Bwrd ol Ta� fAmmissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19_2�
io Be FileO in Uuplicate
SEE BACK FOR FILING INSTRUCTIONS��y� �/Q3/_Od
,,,,., ��)�� �, o
�(We) -�����4-¢-� ,�?� -�O�'�^ �- certify that on the tst day of
arch, 19 I, (We) occupied as our principal place a� e de ce the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial iA te�est in
Property Description in--9,�=�+�
Taxing District (Lity—Tov�n, Township):
Parcel Number
If buying on contract: Owners
o��-/� 3�-�44-06/.4a3G-Q��
[he taxpayer
County Township
,-�-�
owneq
or Jegal description shown on tax statement
��
, �� % 3�?- 3 - i/ . 7o/a�ceci
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:
certify [he above statement is true, correct and complete.
.
1. ' a
- — '---- -..
County
�
Township
3igna�0y V Street naaress _ V ' Cl:v. Sta:e ana 2iD �e
l��,,/y-
��IrfEiividual either owns or is buying under a contract that provides he is to pay the properiy taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1(one) �a�cre immed ately ��
surrounding residential impro'vements �
Other Land ,
Total Land
-'��� <u 1979
Residential Improvements � p u�9
, � ����ge .
aUOi���
Other Improvements
To' ' Improvements - Line (6) plus (7) equals (8)
1-�by�rec�fy the above is true. correct. and complele.
Sgwwre ot
Approved
True Cash
Value
(t) ..5—Od
(2) `_
(3) S—� D
(4) /S`f�7o
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- ACTION BY AUDITOR -
Assessed
Valuation
/ 70
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Homestead
Va�uation
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Date: U// 7�