Homestead_Cochran (4)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
/ State Fwm 5473 (RB I1-03)
Prescribed by ihe Department o1 Local Govemment Finance
INSTRUCTIONS: See reverse side lor liling ins(mctions.
FORM YEAR
HC10
i'
� � � � �
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I(We) certi(y thal on Ihe 1dt day of March; 20 /1
I�upied our principal ptace of residence the Ilowing described real property for which a Homestead�Propertyi�a„c.Credit is�heretiy daimed:
I (We) owned ❑ Ne buying under contract � �3a0� : � . "� ., .
, Have a benefidal interest in the entity �hat is liable for the property taxes on the pmperty and fhat owns the property or is buying under a conVaU.
If buying om m�irad, Fee Simple awnefs name
Recoidefs ofice vrhere contraq is
County
H any
af the
Rewrd number � Page
Tamship
V ��WIVVV �/�/V -
����r (��/'�� al des Ron ///� Is the property in queslian:
��J �,�p � r/� 3 � Real property ❑ Mobile Homo (I.C. 6/.1-n
ol Ue residenlial sWCture or Ne IanA nm axceeding ane (1) ame ihat immetliatey surrounds that swcWra is used W produce income, describe Ue use and portion
y utii¢ed b D�odute income. �/
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I hereby certify the above sUtements are We, corted and complete.
Address (numbe�aM streef, city, stafe, ZlPcode)
Land not exceeding 1(one) acre immediately
surrounding residential improvemenis.
Other land
TUaI land (line 1 plus line 2)
Dwelling
Residential improvemenffi or Mnuatly �
Assessed Modb / Alanufac�red Home Garage
Other improvements
Tcial improvemenLs (line 4 through line 6)
Total value (line 3 plus line �
I hereby certify fhe above is We, corred, and
complete.
Vai(ying action - SignaWre oflwditor
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SignaWre of Asseuor
County
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Date signed
Date signed
�._.•,���'-..�.�".`'���.`-�',.ss,:-.., '-.�,.3rr�.--?.�`�:=;STANDAR�_DEDUCTION'ALL0IAIANCE;ti'_�„'1'�s`�;a`�2zn..`�tu'=a•'-'�".`'s�e��'..�.i�'�`r'�i�`,`:a?''#��`s.t�'�at.
r
20_Pay20_
Lesser of 1/2 Homestead $
Ve�uanon or E35.000
Synature otlwditw � Date signed
Sf�TE roMf v5aa IMJ � b�q
TPFA SL'RFII I00.N TS� 1 A
PPES[N�B�L 6Y T11E OFP.U(TAE�i OF L(1GLLCAVOf\MEY! F44A'L.41C Lt.l-:]2.1
Gibson County Auditor � � � � � � � � �
101 N. Main SVeel �ndividuals and married couplcs are limited m one homeuead standard deduttioa As ;he rtceipt of this Mluction becomes
PfIf10EtOf1, IN 47670 more brneficial, thcre is morc incrnti« ilwi ncr for Iromestead Gaud. Homatcad (rzud causes highcr tax bilis for all; �hercforc.
� � HEA i344-?009 requires taxpayers wtw recci�c ttie homestead standard deduction to vcrify that they are eligiblc io rccei�T the �
F I I� E D benefil and to prmide fldditionnl idrntl(}ing in(omwtion nccessary W allox county gmemmem to beaer moniror homeztesd
filings. This in(ormsion will bc kep� conldcntial and can onty be acccssed by auchoriud wunry ofTcials. Thc Depscrt�rn� of
I.ocal Grn'emmrnt Finantt x�ill ust �his infortnation [o cream taols iha� will help rnunry of5cials eliminate homes[ead fiaud.
_ APR 19 2011
— c.�.m�
GIBSON COUNTY AUDITOR
1105
John R Ccehren
1551 E INDIAN CREEK EST
PRINCETON IN 47670-8972 '
Taxoaver Name
Cochren, John R/Carolyn R
�
I II�I�III��III �II�� �II II�I I III
Lowtion Address
1557 E INDIAN CREEK EST
PRINCETON IN 47670
I II I� II�I I� I I ull� II�I �I� II II
�I��II�'�����II�III"I'���'I��li��l�lli�lll'��II�'I�I�iI'�'ll�l�l State Parcel Number Leqal Description
� � 26-12-09-103-004.064-02� �NDIAN CREEK PH III 1!2 PT C-1
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.
. / U H�r/ I �.
lailing Addrtss (n�ba a� strccL city, stau. and Z[P codc)
�5�.i/ � /tioi.l.v C.�cc.� F�"/.
�ocial Sccuritv N�bcr (tast 5 dieitcl Drivcr's LiccnselState m Ntmmbcr
� �/! OL }�/i/
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ch/'E;�
as property eddrtss
Othcr (plcue spccify in Part 4 below) .
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Middle [ . Last
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"-" ' �: �( Same as piopeny address. . .'- __ � _ _ . _ ^ . ' — '
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undersigned certifies, under penalty of perjury, that [he above and foregoing infoimation is we and correct and thaLhe or she is eligible m
+e the homestead standard deduction on this property. Each undersigned also understands that, by claiming additional homestead deducnons
+fully, he or she may be liable for back taxes and substantial financial penalties. - � �
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