HomeMy WebLinkAboutHomestead_Livermore (3)� } CLAIM FOR HOMESTEAD PROPERTY iAX FORM YEAR
CREDITISTANDARD DEDUCTION HCto
� Slate Fwm 5473 (R614-03)
Prescribed by the DepartmeN of Local GovemmeN Finance
INSTRUGTIONS See revcrsc side loi h6nq mslmcfions. �
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s�� � � '"'�+�'Z-CERTIF.ICATION� ATEMENT"r'�.� ""� �J s� 3.�� - ° "
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I(We) ����� "Yn U' K certi(y tAat th 1sl d.�ax^ of March. 20_
I(We) oaupied as our principal place oi si ence lhe foll wing described real property (or which a Homestead Piop�y ��rR�MI�}hereby daimed:
❑ I(We) owned ❑ Fve buyin er contracl v/
� Have a benefidal interes[ in the entlty Nat is Iiabie for the property taxes on the property and that owns edropeaty,5 ✓is.� V un�r a nVaU.
IESON C�n� ir,i � . _
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I( buying on conVad, Fee Simple ownefs name
Remrdefs olfice where contraq is recordetl
ftecord number � Page
� Tamship 7ating tlistrict (ciry town. fo hi 1 y
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Parcel nu/m�ber Le9al description Is Ihe property in question:
DO(�'O � Real Droperty ❑ Mobile Homo (I.C. bf.f-7)
N any portion ol Ue resitlenllal sW cture or Me Wnd not axceeding one (1) aae that immediatety surtounds lhat swGUre is used to produce income, describe the use and portion
ol the properry utilizeA tn prcWuce income.
Caunty
I hereby certify �he above statements are We, correct and complete.
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F� YJ (%1 V / /
Coun�y �ToxnShip
20_Pay20_
Lesser of 1/2 Homesread
Vaivauon a 535.000 g
Dale sjpn� ` � —O
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
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SiATE fOR\I!!MIIL)sV�1
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IndiviJuals mW ma;riN coupks arc limited to one hnme.leaJ aandaN �kWuciion. As �he �eceip� ot ihis ticJunion become�
morc beneficial, thrrc is rtrorc incrntne dun e�er for homrstead fraud Homeittai fiauJ causc higher tac hills in all: therefur.
HEA I i�f3-?Iq9 requires mspayen r�ho rmi.r the hancsteaJ s�andmd JNuction m rerily tlu� thn' me eligiWe m mtei�e ihe
benefi� aN tu pnn'iJe mWitimul idemii�'fn_ infurm�twn nece.sarv to allux' counq� @a'rmment tu betrer munitor humestt:xl
�ilinb�. This info�mmion will M Ary4 con�idenlial and on nnly h acrosed by awMrivd cnunry� Mlicialti. (7Tr Ikp.inmcnl nf
Local Gmemmrnt Finance ��ill u.e this intormatiun m crcate t.vls �hat �afll hdn camn� w"ficial. dimimm kimestead tiauJ.
Taxoaeer Name
Livermore, Bobby R/Neena F
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Princemn IN
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Bobby R Livertnore P r� n��
2997 E Curtice Lane State Parcel Number Le�al Descrip
PRINCETON IN 47670-8870
--- 26-12-15-100-001.539-027 oos�ols3s-oo PT E E
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.ig Add+ess (numbcr and ;vm, <ity, sum, and ZIP codr)
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imc as pmpcm edMs;' _
(plcae specif in Pan 4
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TRACT 6 15 2
mdersigned certifies, under penalry of perjury. [hat the abovz and foregoing infortnation is we and cortect and th�t he or sh'e is elieible to
e the homesiead standard deduction on this propeny. Bach undersiened al;o unders�ands that, by claimine additional homeslead deductions
fully, he or she may be liable for back taxes and substantial financial penalties.
I Signawre � Dem 7'cicphonc
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