HomeMy WebLinkAboutHomestead_Connorr���CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
/ State Fortn 5473 (R6 / 1-03)
Prescnbed by lhe DeOanment of Local Govemmeni Financc
INSTRUC710NS: See revc�sc side !oi liliny ins6uclions.
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AUG 0 2 2003
� ('/re) L/ � � � ( "��Y7CL� ��In( /X � /� f ZG`'��/:l�°�`„`"(� ��/
- � certirytFiat.on,thed3t'dayoi.Mardf,'20�
I(We) occupied as our principal place oi residence Ihe following described real property for which a Homestead Property T� Credit is hereby daimed:
❑ I(We) owned ❑ We buying under contract
' Have a benefidal interest in ihe entiry that is liable for the property taxes on the property and that owns the property or is buying under a wnVacl.
If buying on conVact, Fee Simple ownefs name
ofice where conVaq is
ro,msnip
descnpUon
H any portion N Ne resiAential sWdure w the land noI exceeding me
of the properry utilaed lo produce inmme.
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Rewrd number � Page
Is the properry in
� Y�YRea� YopeM U�b0e Homo (I.C. 61.7-�
wrrounds that s Cure is used to praduca income, tlescriba Ne usa and poribn
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"��:�* '� t ��e���l`��.'"�3 ��`�7��,Yisr::STANDARD:DEDUCTION`ALLOWA!lCE,�;;T.��.� �:�.,���; �-�-�,�,-�����
20 _ Pay 20 _
lesser of 1l2 Homestead S
' vawauon w E35.OW
Signature of Audilw � Dafe signed
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Gibson County Auditor
101 N Main �
PRINCETON IN 47670
395
SI�iE FOR)1!IMIIC'! HMI
1RfA5UAFltlO0.411A
InJividual.� anJ rturtid roupkti arc limned io orc homeaead �andaN dedu.�ion. As thz rttcipt ol Uti� dcdunion bttomes
morc beneficfal, there is morc incenin'e th�n r�er (or homra�ead fraud. Hart�,ead fmtW cauies hi�her �a� bills (w all: thrrefae.
HEA li+i-?OQ9 «qu'ves iaipapcn .vho recci.e ihe hanestcad standard Jnlunion w.erity �fui thcy are eli¢iMe m reoei.e �he
benefi� aN ro pnw�iJe a4liiional idrntifyinc in(urmanan nece.-vrv to allw' cwnp� gcn'emment to W[¢r munlror homesteaJ
tilin��. ILis inlormvinn xill be Aryv mnfJeniial anA ran only he avres¢J bc aulhnrizeJ aoumy nnicials. �fAe IXpannrn� nf
Local Gmcrtmiem Piv�rce ��ill ua this fn:ofmation tu crea�r hvls tlu� �rill hdp cqmrv officials diminam humesteaJ freud.
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Taxpa��er Name Prupertc Address
Connor, Charlotte A
Chariotte A Connor
111 N 3rd Ave
PRINCETON IN 47670-1009
�i�u��u��i��n�ni���nun����in��in�i�n�n��ui����n��
III NThirdAVli
Princeton f\ ;7670
State Parcel Number Leeal Descriolion
X 26-11-12-103-001.834-028 019-01834-00 TOWERS HGTS 117
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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Owna I First Middle Laci
' �o e no
�e Addi¢s (number and ;rtceL ciry, smtc, and ZIP code) � Same as praperty add�-.
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Social Sccurity Numbcr (last 5 digiLS) Uriver's Lic<nse/Sute ID Ninnbcr Qas� 5 dicib) Other (please speci[ in Pan 4 below)
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SpouK First h1iddlc Last
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Mailinc Address (Number anJ svre�, ci�y, s'iate, anJ LIP cuik) � Same n� pmpem address
Social SccuriR� Numbe� (lact 5 digits) D"m•tt's Licca�e/Statc ID Nwnbcr (la;t 5 digiis) Othcr (plcuc spccify in Part � beloa)
sme
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Fach undersiened certifies, under penalty of perjury, that the abo�•e and foregoing infortnation is we and cortect and [hat he or she is elieible to
receive the homestead standard deduction on this property. Each undersi¢ned al;o understands that, by claiming additional homestead deductions
unlawfully, he or she may be liable for back taxes and substantial financial penelties.
Ox�Mr 1 Sitmanuc Dmc Tcicphone
.� � 6�o (
Spou;e Sig�aturc Datc Tcicphonc
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