Homestead_Cockrum�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
0
2231
1RlASVl[Af00.4 3)A
R f P'A\fE I(' b I.1.1_-1.1
hWividua� and ma:riN roupk� arc limiied io onc homc9caJ �tanAaN Jetlunion. As ihe �ttripi oi �hi> dcctunion becwnc
morc beneficial, therc i� morc incenti�Y than aer for homa�.'rc:wl BauJ. Iiomestta�l GauJ caus.s higher tac bills' tur all: thercfure.
HET I.4i-?IX!9 requvn u�pare� x�ho receive �he hanrs�eaJ s�andard deJuc�ion m verily �Iw� �he� am diCiMe �o rccci�c IM1e
benefit anf [o pnaide adilitional iJemii��im_ inform��wn ixcr.san to allw' cwnn� go.'rmmem ro N_ner munitw twmesreaJ
hlin�,�. Ihis inlo�maiinn vili M{.tp conlidcmial and �n nnly h acee>¢vl by audwri�d rounly nlFci:�ls. �fhr Ikpanmrnl nf
Lucul Gw<mmcm Financc ��ill uu Ihfs infurma[ion to cmatc ¢vls iha� �rill h:Ip ia�nrv ufficials dimi�uvc hum<sicad haud.
. • , , . , .
T•rxnaver Name Prupertc Address
Cockrum, Dan . /
P O 6ox 5 �%1i'�
Princcian I\ -07670y
Dan Cockrum
1499 E Conservation Dr
PrincetonlN 47670-8608
I�I��II���I�II��I���III���I��I��II��II���I��I�I�I��I�I���II��I
.'.dd:� (s.r.ib..^r a.L s^xt ciry: s.:.:c: md ZI °:od: j
va�2rt� -
Address (Number and slrttl, ciq�, siate, nnd ZIP cu�k)
9�j E Co�se���+�o,-,
xuriN Numbcr Ilact 5 dieiLS) Dm�ttt Liccnx/Stai
5
n
State Parcel Number LeQal Descrip�ion
26-12-05-400-790.994-027 o0croossa-00 CneIN ON LSD GROUND
_�Sf �,� TRS F& W CONS 00&0057400
�/ � f-
�oC K R u vv� I
Semc � p••,�rm �ddmsc"' _ - _'_ _ _ __
(plc�se specify in Part 4 bdow)
�0 C. �� �^C7 r+�
� $ame uti pmpem addtts
r= h'r� r,cefm. ..L� ��l�
iber (lazt 5 digits) Othn (plcasc apcciF in Part: bclow)
Each undersicneci certifies, under penalry of perjury•. [hat the abo�•r and foregoing information is trve and corrzct and that he or she is elicible to
receive the homestead standard deduclion on this property. Each undzrsiened al;o understands that, by claiming additional homestead deductions
unlau�fully, he or she may be liable (or back taxes and substantixl financial penalties.
I Sigmnuc
(��� )
..�^•.. -
E' ; CLAIM FOR HOMESTEAD PROPERTY TAX
}; �;; CREDIT/STANDARD DEDUCTION
,�;• State Form Sd73 (R2 / 5�92)
�u� . .
INSTRUCTIONS: See reverse side lor filing instructions.
� .. �� CERTIFICATION STATEMENT ' ,-
FORM
HC10
YEAR
q3
I(We) �/l.� � � L-(`T{ A/ �l A_/W� certify.thai on the 1st day of March, 19�
1(We)yecupied as our principal place of residence the following described real property tor which a Homestead Property 7ax Credit is hereby Gaimed:
/
�We) owned .❑ Are buying under-coniract � .
� rlave a beneticial irnerest in the entity that is liable tor the property taxes on the property and that owns the property or is buying under a contraa.
� � . CONTRACT RECORDED � � . ' �
If buying on contrap. Fee Simple ownefs name . , . . . • _ - � �
Recorder's ottice where Contract is recorded Record number Page
Counry
Parcel ^number
�C)� �O
It any ponion ot ihe resid
Ol lhe property utili2etl to
PROPERTY DESCRIPTION
Township � �
Legal description
town,
stmcwre or the lantl not exceeding one (7) acre that immediatety surwunds thai strucWre is used to produce income, describe the use antl ponion
ice income.
� PROPERTV OWNED BV CLAIMANT IN OTHER COUNTIES �. `
Counry Township County Township
I hereby certify the above siatements are true, correct and complete. Signanre of claiman�
zss (number and sveef, ary, stafe, ZIP code)
ASSESSOR USE ONLY - TRUE TAX ASSESSEO HOMESTEAD NON-RESIDEN'fIAL. -
VAIUE VALUE VALUE VALUE �
Land no� ezceeding 1(one) acre immediately
surmunding resideniial improvements. (�) ��
Oiherland (p�
Total land (line 7 plus line 2� (3)
Dwelling (4) .
Residential improvemenis
Garage (5) '
Other improvements (6)
Total improvements Qine 4 fhrough line � (7)
Total value (line 3 p�s line � (g)
I hereby cetlify Ihe above is true, correct, and Signamre of Assesmr Dare siqned
complete. �
Veriyirg aaion - Si9namre of Auditor Date signed
� 19_Pay19_
Lesser of t/2 Homesiead
Valuation or 82.000
DEDUCTION ALLOWANCE
5
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