Homestead_CowanCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
} CREDIT/STANDARD DEDUCTION HC�o
State Fwm 5473 (R6I1-03;
Prescribed by the Department of Local Govemment Finance
INSTRUCTIONS: See reverse side forlling ins(mctions.
' '�' •�5.-.���'��Y,��`¢�`9i�?'�'�.,t��'.i.��`#'_.`.,=`-'�CERTIFICAiION STAlEMENT�,r Y�`.`-� ` " &� -� �
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� �e) certify ��n C�e�lst��f March, 20_
I(We) occupied as our princi place of residence the following descnbed real property for whicli a Home d Property T�c Credit is hereby daimed: `
❑ I(VJe) owned ❑ Fve buying under contract
� Have a benefidal interesl in �he entity Nat is liable for ihe pmperty taxes on the property and Ihal s Q��g �� �n Ji � wnUact.
11 huying om m�Vap, Fee Simple owners name
Recorders ofice whwe conVact is remrded
County - Tamship
P I number al descripiion
a - �as-
If any portion of M8 residentlal sWClure w the nd not axceeding one
of ihe properry uWized to produce income.
Record numEer � Page
Tacing district (city, rown,
property in question:
❑ Real property ❑ Mobile Homo (LC. 6f.1-�
that shucWre is usetl to produce income, desuibe tha use and portion
����'�����'� r'�*��,`r--"��.' � TRUETAX�� ASSESSED VALUE '�HOMESTEAD�� ``" NO ESIOENTIAL��
� ASSESSOR�USE ONLY� 'a' � �
-��Z��y.�_+�,�;,,v�g�;.� "" i t `" '�5 �VALUE�` �� �`AT�100%'OF�TN�., -�"� FVAL'UE� ��',��is1�VALUE�"'�.�"�x
Land not exceeding 1(one) aae immediatety = ¢�'�;� � '+ Ti � Y°„__
suvounding residen6al improvements. (�� ���-c.�=���.ca-,�
>
r . �
Otherland (2) �''. -..�v��
;_: �so-c
Tdal land (line 7 plus line 2) (3)
- A .��,r,�,na.- e wx.... �s':*a
Dwelling (4) ,' ,5� = �€ ' � }
Residentlal improvemenLS or MnuaOy �4,�°' r�,3�"�"yS�� .
Assessed Moblle I ManufacNred Home Gara e ���� i-r�= '�.��'� ����.
9 (5) �,�. �±x.�:s�_'�=� '.'i��-'z+-'�
Oiherimprovements (6) � `''�"� ` ���a
' ���'�T...�
TUaI improvements (line 4 fhrough line 6) �7)
TUaI value (line 3 phs line � (g�
I hefeby certify fhe above is We, corred, and Signature o(Assessor Date signed
mmplete.
Vrrifying acl"an - Signature of Nitlimr Date signetl
,.'r`.��. �',�::�� tg�,35i;Y."t eYsiu�-�a_.��3�s, ,�:�,.'`�STANDARU:OEDUCTION AL'[OVJANCEi!`��'"�tix�`L-+�.5'"w`t,;,"'�,c,,�t-�^*',,,.1 ���.�-.r!?s3e.�--..�.z
-�---ta-�a...-r' ,�
20 _ Pay 20 _
Lesser of 1/2 Homestead $
vaivauon w E35.000
SynaWreofPuChw ' DatesignM
715
Gibson County Auditor
101 N. Main Street '
Princeton,IN 47670
srnre ronm vsev0.+�e-io) iwnsunrx ro..N n.0
APPPWEDBYSUiEBMIiDOfK'(DUY�SXM P0.F_SCRI6EDBYTff.OPAATME�TOFILG�LCA�T.R\ME`?FINA`l�IC6�.1-I1-0.1
Ind'n�iduals and married rouplec are liminxl m ane homcttead standard deductiou. As the receiyt of this dcductian hernma
' more bcneficial, ihe�e is more inrentnr than ncr (ot homcstead fmud Homaiead fiaud cavses higha uz bills for all; lherefort,'
� HFA 1344-2009 mquim tacpaycrs wtro recenc ihc hamcstcad srandard deductian m�crify [ha� thry are.cliFi6le to recei�x chc
� . brnefit end to prmide addilia�l idrnti(��ng informatlon necessary In allox� couny gwemmrnt to beucr monitor homatead
filings. This informmian xill be kep[ con5dential and can only he accessed W authotizcd comry ot5cials.'!hc Dcpazment of
�. I.acal Grn'emmmt Finuice will� ase Ihis infortnation ro crtate tools chat will he1D munR' officiais elimiriate tmmcstead frxud.
Taxpayer Name `
Cowan, Douglas S/Elva G
Location Address
407 W Brumfield
Princeton IN 47670
' Douglas S Cowan I(I�I�III��III ull�l �II II� II �III �I�I'II��II�ll�lll �Ilul� III�II I�ullullul�ll I� III
911 S Hall
PRINCETON IN 47670-2333
�I��'��II�'�'�II�II'lll�'�I��'�"I'�I'I���I���"'I�����"'�'I'��I State Parcel Number Leaal Description
— � g � � �6-12-07-103-001725-028 BROWNLEE ENLG SPTl9
- " _s" -- J' � - - �- -- - - - '— - -- -- - '- - - - - -
� ` JUL 5 2011 `
c.�. " V
, I N COUNTY AUDIT R
This form MI�S�'�be returnec� to County Auditor's office.
Please do NOT send this form back with your tax_ payment to the county treasurer.
S
ng Address (¢umba end strcn. ciry. s[aic, and Z[P code)
tib7� I3�un-rnFi��d Prince
1 Securiry N�6cr (last 5 di¢its) � Drivefs LicensrJSUte � Number (last 5
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ailing Address'Cn��* � ie�4
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xial Securiry Number (lut 5 digiuJ
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as propern� address
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Part 4
undersigned certifies, under penalty of perjury, ihat the above and foregoing information is we and comect and that he or she is eligible to
;e the homestead standard�deducrion on this properry. Each undersigned also understands that, by claiming addirional homestead deducrions
;fully, he or she may be liable for back taaes and substantial financial penalties. - � -
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