HomeMy WebLinkAboutHomestead_Sullivan (3).�;� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
♦ � Sta�e Form Ss73 (R6 / �-03;
PreStn be tl �y t he Department d Local Govemmen� Finance
INSTRUCTIONS: See revcrsc sidc foi lilinq inslruc6nus.
FORM �I YEAR
o S��
�w... .
�(�'�e) GZ- certify lha[ l� arch, 20
I(We) occupied as our � ci al place o( residence Ihe following descnbed real property for which a Homestead Prope��redit i ereby Gaimed:
❑ I(We) owned Are buying under conVacl
C3(BSON COUNTY AUDITOR
� Have a benefidal' terest in the entlry ihal is liable for Ihe property taxes on the pwpeny and that owns ihe property or is buying under a contrect.
: rX r:. . -�,,. :,H=';:•-P.ROPERTYDESCRIPTION`-` . .. .
J�nry� Tavnship Tacin9 ' t t(c�ry. to)vn. rownship� _
Parcel
Is the property
�� - �i�r.�a�-UO i YJf �1� .� � -ia �
If any ponion ol t�e resiAential swcture w the Wnd not axceeding one (1 � acre t�al im ediatety surrounds
of the property uWized to produce income. �C
County
Township
I hereby certity Ihe above statements are true, corred and complete.
Address (number and s(reef, ciry, stafe, ZlPcode)
County
of
Real proPerty ❑ Mobile Homo Q.C. 61. f-7)
ae is used to produce income, describe the use and portion
�:�i i Ce � l u �{
Tavnship
'�`"�`'� S � ` � �� TRUE TAX ASSESSED VALUE . �NOMESTEAD - NON-RESIDENTIAL,
�-a� j� " ASSESSOR USE ONLY
r,?tir�� -::_•r,. �.: ,..=- - ;. : . . ' " � � VALLIE � AT700%�OETTV ::_' VALUE. :;.� ...' ..!, itVALUEI �. �
Land not exceeding 1 (one) aue immediately . - - - '� -. _
surrounding residential improvements. (�) , . � - ,_ -
Other land �Z) - " �
Tocal land (line 7 plus line 2) (3)
Dwelling (4) . - , �-
Residen6al improvemenLS or Mnualty � �� � �'� '�' °-� `
.�.x. � .._: .'
...�-sc.: �:�.::; ��--.� :�--'
Assessed Mobile I ManufacNred Home Garage (5� ..., � �
ONer improvements (5) �
Taal improvements (line 4 fhrough line 6) (�)
Tctal value (line 3 plus line 7� (g)
I hereby certify the above is We, conect, and Signawre ofnsseswr Daie signed
complete.
Ventying action - SignaNre otlwditor Date signed .
_ t.
�c� "�.a=; . - ,G;.. -- ,.;.?::: - -. .ST/WDARDDEDUCTIONALLOWANCE`.-- . � '- .,�,� .. .
20_Pay20_
Lesser of 1/2 Homestead
vauauon or 535.000 5
SgnaWrooflwtlitw - Da�esigned
sw[ roxa s�sw 1�� ��m
�ns�.trroaaTSu
Gibson CouMy Audilor � � � � � � � � � � � � �
101 N. Main Sheet � t�a��td�i: snd married muplcs are limiced to one home'uead sUndard dcductinn. As the receip[ o'this deduction becomes
Princeton,IN 47670 J
morc brnelrcial, thcm is morc inttnuvc ilw� e�er (or Iwmcstcad G�ud.Homcs�ead faud uuscs highcr ax bills (or all; thcreforc,
EA 13Y4-?009 rcquires ta[paysrs who recen'e thc homcsicad standazd dedu<tion to �2ri(y thi[ chry ve cligibic ro reccnr thc
I L E I�c61 avd to prmide additional idcntifi�ng in(ormaUOn nccessary w allow county gmemn�ecl to bettcr monitor homcstead
• filings. l7vs informacion uill h kept confidrncial and can onN bc accesud W auUror'ved cown� alFrials. The Dcparnnrn: of
� l.ocal Go�'<mment Finance will use Itiis information ro c+eam mols [hat will help counn� officials eliminate homesttad fraud.
AUG 1 5 2011 � � � �
C'J.n- " V
GIBSON COUNTY AUDITOR'
2243
—�-� _' � Richard�L Sullivan =�—"':''" "—�' e° � �III�I
�� � clo Wayne Bourassa II
. PO Box 422 ' �
PRINCETON IN 47670-0422
���I�'�114�'I��I�'I��I'III�L���l�����l���ll���l�lll�d�l�l�l��l
/3los �/1 �i� /�,
Taxpayer Name
Sullivan, Richard L Trust
�
0 r
PRINCETON'IH 47670 '
I�I I��II��I� �IIQ��I��III��II�I���II����II�I�III;�III�011�11�'�i� ��111�-
I
itate Parcel Number Leqal Description � -
I
2612-OS-200-001.238-027 PT NE 5 210 4 AC � C-7
,
o ;
Th:s form MUST be retumed t�� County Auditor's office. '
Please do N07 send this form back with your tax payment to the counl.y treasurer.
/ �,,,.
�N�yr.� I a.v�
failing Add}ess (number and strect, city, stau, and Z[P codc) '
�• G •' �oX �2Z �r�nce�"vv� /l�l
ocial Sccuriry N�bcr (latt 5 dipu) Drivcls LicensrlStau m N�bcr (last 5
. I
Address (\umber and streeC ciry, statc, and 7.IP code)
Number QaSt 5 digiu) I��'crs Licensc/5tatc m
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�
• p c� ra 5 S�
• n Same az pfopcny add+css
y 7(0 � o
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I / I ' ' I sme
(plcau spccify in Part 4
.❑ Samc a5 properry address I
t
Other (plcasc spai(y in Pari <
�... _ _ _ . - I
undersigned certifies, under penalty of perjury, that [he above and foregoing information is we and correct�and that
�e the homestead siandard deduction on this property. Each undersigned also understands that, by claiming additionz
�fully, he or she may be liable for back taxes and substandal fmancial penalties.
� $9�a� Date Telephone
>�� 7-3-i� (
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