HomeMy WebLinkAboutHomestead_CollinsGibson Counry Auditor
101 N Main
PRINCETON IN 47670
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1049
lli�£FOA\I!�W 10./S✓�1
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fnJividuaL. and rtu:riN coupka are limited io one home�e�J �randaN dttlu.�ion. As �he rttript ol this dcduaan bttronres
morc benefiNal, there is morc incrntnr than rcer (or homr.�ead :raud Hom veacl fiaiul caasa h�Ixr ux bills tw all: there;ore.
HEA 13-4i-?IXI9 requixs taxpa7crs v:ho receire ihe hacescead smndard deAunion tn .e'Ny that tM1ey am eliciMe to recene ihe
benef,t aM m p�m�idc additio�ul iJentii)'in� in(wmatiun neca�'.ian� ro ailw' counn� go.rmmrnt �o Y.tter rtronitw Iwm�neaA
nliew�. This in(omu�ion x�ill 6e Aery mnfidrn�ial and on only he accescnl b. amlar'vN rouniy olTmials. T6e Ikry�artmeni o(
Lceal Gmertvncm Fivnce ��ill u�c this infomu[ion tu crcam twls �hat miil h:lp cpmn� offirial> <limiw¢ homcsicad fraud.
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Tasparer Name Prnoertv Addre�s
Collins, Ann
Ann Collins
428 E Water St
PrincetonlN 47670-2256
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d2R li R'at�m 57'
1'rincc�on IN 47670
Stare Parcel Yumber Leeal Description
� 26-12-07-401-001.263-028 019-01263-00 ARGHERS 2ND 20 PT
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.
�
O�.�n<r I First Middle Lazl
� L1 N � �'� l-1� S
�e Address (numbcr ond ;tcccL cirv, sta�c, and ZIP code) Same a5 property addj¢;
� � � �N o•�/Y t �\ ' � N �—1 �0-1
Social Smrin Number (lasi i digits) fhiver'
Spou;e First Middle l.att
Mailine Addiesti (Number an slrce4 cily, stale, nnd LIP cak) �$;une as pmpeny add�ai
Soeial Stturitr Numbtt (last 5 digi�s) DrivcYs' LicensdSrate ID Nwnber Qy� 5 digies) Oeher (plcsse specify in Part 4 below�)
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" _ _ _ _ _ , " _ '
Each undersienetl certifies, under penalry o( pequry, that the abo�•e and fore�oing infortnation is we and correci and that he or she is elieible to
receive the homestead standard deduction on this property. Each undersigned also understands tha� by claiming addi�ional homestead deductions
unlawfully, he or she may be liable (or 6ack tares and substantial financial penalties.
Owoer I Signsnrte Datc� � 7'elephone �� �`����
�1��� �-J�'4-� � �4 � a � � � �
Spouae5i�amre Datc icicphone /
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11 1 � 1
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`N� CLAIM FOR HOMESTEAD PROPERTY TAX
�° � CREDIT/STANDARD DEDUCTION
F
Sqte Fortn 5473 (R2 / S9
S � !�-�
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INSTRUCTIONS: See r r'� ins((�rc �ey�7� \ p,
i
FORM
HC10
YEAR
... � ..- —=�.... :-�:CERifFTCATIQN5fibTEalE!(T; `. ,°-'.�..," .-�=.; -
I(We) _ certity �thC�,p�i t��t��f �March, 19_
I(We) occupied as our principal place of residence the follovring described real property for which a Homestead F�ropre y � i hereby claimed:
❑ I(We) owned ❑ Are buying under contract
� Have a beneficial interest in the entity thai is liable tor the property taxes on the property and ihai own �� R., -ntract.
GIBSON U T
,.. ' . ._ .. CONTHACT RECORDED�. � _ ' ,�., � - ,`.`;i - :^ ' °
Ii Gryirg on con[raa. Fee Simpla owner's name
Recordefs oHice where contraa is recorded Record number Page
. . ' � . . . "� . . � " PROPEF
COUnry Township
P rcel m mber Legal descnpti
_,
It any portion of the residential s[rudure or the tand not ezceeding one (1) aae Ihat
ot Ne property Wlized to protluce income.
PROPERTY OWNED BY
Counry
I hereby certify the above statements are true, correct and complete.
jddress (number and sfreef, dry, state, Z/P code)
IIPTION ' ,9. ,_g:.- �..�ti.., _ .._
g distriq (city, town, mwnship)
�� ao
surmunds that siructure is used ro produce income, describe the use and portion
.��:!
- ASSESSOR USE ONLY � TRUETAX � ASSESSED NOMESTEAD . NON-RESIDEHTIAL ':
. , VAWE � VACUE, VALUE VALUE �. �
Land not exceeding 7 (one) acre immediately � - - � � , "
surrounding residential improvements. (�) �
,
Otherland (2) ._�s�=�.. '
Total land (line 1 plus line 2� (3)
Dwellin9 (4) �. � � ' . .
Residemial improvements � .
Garage �5) � . �
Other improvements (6) �
Total improvements (line a through line � (7�
Total value (line 3 p�s line � (g)
I hereby certify the above is true, torreCt. and Signature of Assessor Date signetl
complete.
Veritying action - SignaNre of Autlibr Date signed
79_Pay19_
Lesser of 1/2 Homestead
Valuation or $2.000
3
�
0
Date signetl^
�J � Y —