HomeMy WebLinkAboutHomestead_Harper (3)CLAIhR FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
smm r«�„ sar.� �� i sas�
Preaabee by tlie �epatrrient of Lool Goramere Fs�
INSTRUCTIONS: See ieverse side !or filing instructions.
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SEP p � 200
I(We) � Y cer(�,@�i ��d�e 7 st day oF March, 20_
I(We) ocn�pied as aa {ac�dpal plafc of resider�ce the toBowirg des�nbed real property which a Homestead Properiy Tmc Credit is hereby daimed:
��(We) owrwW ❑ Are Wryug unda cantrad
Have a bercfidal mEare�'u� the entily Mat is liade 6w C�e popeAy fmces m the property and tliat owns Ne property or is buyvg under a contracl
tf buy"og on �mtracl Fee Sirtq�e wmefs reme
f�ardds of6ce wliae
�h
Paioeinm,ner
Tonslup
_ p Z'� �eaei de�,�vcm
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�`�J• m1Yl�.
Is the paparh en
Recvd numher � Pege
�b,�'�-�1.,-icx�-Wo�.zz��lil1�-2-1Q ,��il�at�I �Rw�r LJ�br�,a�i.c.��.�-n
nany pardwi or�,e � cmicwe a u�el�a �a e:me�g ore (�) aue aat:m�ea�ly wvw,m n,� m„m:e is �sea m poduce nwnb. amc,te an �se ana pwon
otUre PwaM utif�d m produce:wmie.
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^:::+. , . ..- �.< ..�,_.�'..�u...:r. ,..�?!'i.'PROPEXIYOWNFD'BYiCIAWANT.dOTHHt�(.bUNTff3�;,._, :,�� `.t:Y-i)�:f.,k.r�.'=e,'S,ij+a:; f.i,�:+
Counly . Ta�nship Counly Towrship .
I M2by oertify Bie above staBertents ae true. mrted aid mrtplete. 5ia'�°a d daimai
M 63�r� a—�
(nurter ero �wt cA: 9am. zm ome)
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� : Y - � � rM � .. r � �� h }i. . ! Ti81E TAX � /6SSESSFD VALUE F�STEADi � . ���NON�ZESIDHi71AL �,'�`a�`+�
� t; r t ...�ASSESSORUSEONLY ... ... � r�„�``.0 :, y VALUEzn a. �AT100%�iTV� 1 ^ .VALUE`�:S-' :�#.r.x.CS�":; VALIIErw:n�. .�'V�•'�f:{.�£';
.. ,w,. , w. <
Land not exce�ng i(one) aae imnediffiey ?+lX51�3G}' y�k��"�, ;;���•g ��
amaadiiplBSiden6alimpo�enwsls. (�) �e� ,��`v�.. ;�T„^,�`�� �`�,,��;,�'yin,�,�;�;
Olherlerd � ' "`':U`';%"='= .
�2� � A'� i J:11^,-`:!:j;
TdA tand (!are 1 pkrs fare � �g)
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OM'eRn9 �<) .r�Ybr�`F�3''�.r�i��:L.7..��+,^�
Resdential imprweiients arAnrwally ..,w.<..,..
Assessed AIOM7e! Manutathacd fiome �� (5) �;�i9z�3"�'t`�v��,�Sr.d 5:��;}�.N� #=?
`v%.±.'�7�..�:wH .a�f ��� ; ;A.�`�
. i•,rpz� '�
Olher unprovm�t5 (6) , . ..
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Tdal "anpmvemenls (fare 4 Uuwn�A 6ne 6) �7�
Ti1al value (I'ure 3 phs 6ne n (8)
I Aereby oartiy tlie a6ove is hue� mrtc�.t md SiBrm�+e otMae�u o-ate sgad
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Veiyi�g adWn - Si�mhve oF Audda Date signed
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- "`h.';r. t,,,> .,9TOMDARD.DE�DUCTIOM'AhI.OWANCEz .'�` ..i� .a�-,.s.,v :rt..... .�.�i-.F:��{
20 _ Pay Zp _
Lesser o(12 Honexead
Valuatian w 535.000 S
Sga�ra d/Wdtor Dafe sipned
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
1335
Matthew R Harper
1980 E SR 64
PRINCETON IN 47670
Sldi£ fOR\I J!M IR' /Ywl
.\f�0.tT'ED BY S4TE B¢VIV Of.M?l: TS 9v
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TItFAiUIfR Po0.V .�-:A
IndiciJuals anJ in�rricJ ooupb arc limited io ore hnmmead sandaN 0.^Aunian. As �hx rcreip� of Nis dedunion becmres
morc beneficial, thrrr is more fncenme ihan e�er (or homorcad fnuJ. Iiomz�eael fiaud causes higher Iac ��ills tw all; �hereiwe.
HEA GJ-1-?INW requim taapa.ers x�ho recci.�e ihe homes�eaJ �tandarJ Jcvluction io veriPo ihm thry ye dieiNe io recene the
benefi� aN ro p`w�idc a�Wi�iotul iJrntifyinc in(wmatwn nxe.'vre ro allw� rounty gmxmmrnt ro beitu moniror Mmrne:xl
�ilin��. Ihis in(omutinn will lr Ary4 crnfidemial and e�n nnly f+t amelceJ br aulMrveA rounty ol�mials_ TM1e Ikrannrem o(
Local Gw<rmmrn� Fiv�ne xill u.e �his intortnadon W tr<a:c Wuls tlu� x�ill hdn camn� offrials dimvum Iwm<smaA fiaud.
Tasoaver M1amr
Harper, Matthew R/Chelsea
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Prooem� Address �
IL Ros 2os (� V
/�r��
Princeton IR 47670 f,� V
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State Parcel Number Leeal Descrintion
2c>>2-i 6-�00-002.22�-02� 006-02221-00 PT E ��w is z io .ss nc •
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This form MUST be retumed to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
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Ountt 1 Fim AfidNe Last
Ma�4hew R ax, N��,
g Addms (number and sttret, ciry, suee, end ZI P cade) � Seme as pmperty odd�;
�b0 E. S�(.l}2 RCac1 l.�-� �Y11'1C��\ , �%1 ��1 L41 �O
Social Security Nunibe� (last 5 digiu) Uriver's LicenselSute ID Nmnbcr Qas� 5 digiB) O[her (pleue specify in Pan 4 below)
Middk Lact
ls t.\ �CS� � � r/�7 � �N.
Mailine Address (Number and stree4 cily, staie, xnd "LIP code) � Same ai pmperty addtc
\A�o � . StA-�e �or�d l�y Pvir�e�br,�1tJ �1����
Social Stturity Numbcr (last 5 dieits) Drivcrs Limn..�efSta�c ID Niunbcr (lau 5 digits) Oehcr (plcticc spccify in Pan? belowy
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Each undersiened certifies, under penalry of perjury, that the above and foregoing infortnation is we and correct and that he or she is elieible to
receive the homestead standard deduc�ion on this property. Each undersiened also understands that, by claiming additional home:;tead deductions
unlawfully, he or she may be liable for back taxes and substantial financial penalties.
O�.'nc( 1 Signanvc [Atc Tclephonc
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