HomeMy WebLinkAboutHomestead_Cutsinger (4)„A� , CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
- � CREDIT/STANDARD DEDUCTION HCto
.'� .. � State Form 5473 (RS / 10-01)
��° Prescribed by ihe Department ot Local Govemment Finance
INSTRUCTIONS: See reverse side lor (ling instructions.
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I(VJe) occupied as our principal place of residence the following descnbed real property for which a Ho e ead Property Tac Credit is hereby daimed:
❑ I(We) owned ❑ Are buying under wntract y(/����� /�'
�4ave a benefidal interest in the entlry that is liable for fhe propeAy Wxes on Ne pmperty and that owns the�bYd6� ON CO PJ i Y fd.U�l TOR t�
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It buying om m�tract, Fee Simple owner's name
Remrdefs ofice where conVad is remrdetl
County Tamship
ber ��„ Leg I trip
If any portion ot the residen6al sWCWre w 1he IanO not exa
of the property utilizeA b produce ir�come. /1 I�
Record number � Page
Tating district (ury, fown, township)
properry in queslion:
❑ Real proparty ❑ Moblle Homo (I.C. 6f.7-7)
1 aae Ihat immediately sunounds Ihat swaure is used W produce income, describa the use and portlon
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20 _ Pay 20 _
Lesserof 1/2 Homestead
Valuation or $6,000
Sgnature aflwdilw � Date signed
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
1098
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InJividua� anJ ma:riN coupls are limiied io onc home�esd �undaN J.Nunioa As Ne recrip� oi ihi> dcdunion become�
more beneficiai, therc is mare fncenme dun aer (or homeYeaJ fnud Iiomo'rcad fiaud causes hisher ta� bills ta all; Ihe¢fue.
HEA 134a 2009 rcquim uxpacers who reccive ihe hanesseaJ smndarJ JNuction to .erity tha� �hey are elieiMe b recenr ihe
benefi� anl ro p�m�ide additional idemiiyine in(wmatiun necesvrv ro alluu� rounn� gwrmment ro brner moniror homesteaA
filir�y. Iltis infarmuion will br F.apt canlidcntial anA r.m only F+e uce.titd 6y amMrized ronnh' oRtiul�.'1'he Uepanmcnt of
Local Gm�crtvnem PinaMC wfll mc �his iniortnaeion eu crcatt tuds ihat will h:lp cnwry oH'icials dimfnaie Mmm>t<aJ fraud.
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Tasna��er Name Propertc Address
Cutsinger, Samantha USabrina E
SamanthaL Cutsinger
639 E Water
PRINCETON IN 47670-2241
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State Parcel Number
X Z6-12-07-402-002.035-028
639FSm&F � �4�✓
PrincctonlN�i7670 �
Leeal Description
STORMONT ADD 21l22123 PT PT
SE 7-2-10.17 AC
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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Owner I First Middl< /� Las�
�Q � l.M��l tl '1%
ig Address (number and svat, ciry, smtc, end ZIP code) nme us prope . -
�O�JCI � �0.-�Ct ��c-. � � � � U`� 1 �
$Otidl $MU(ily Numbe� (last > diGi15) Ihivers Li<eme/State IU Numbcr (la.t 5 di�ib) O�her (plcue specify in Pan 4 belox�)
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Spou;e First Middlc Lan
Mailine Address (Numbrr and �'trer4 cit)', slale. and ZIP code) �nu •vs pmpeny addres
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Social Sccuriry Numbcr (las� 5 digits) Dmrr's License/Statc ID Nmnbcr (las� 5 digits) Othcr (please spcciN in Part 4 bclow�)
sv:
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Each undersi�med certifies, under penalty of perjury•, that the above and foregoing infortnation is we and correct and that he or she is elieible to
recei�•e the homestead standard deduciion on this property. EacA undersigned also understands that, by claiming additional homestead deductions
unlawfully, he or she may be liable for back taces and substantial f nancial penalties.
Ow�C� iymawrc Uate 7'cicphonc
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Spouse Simazun �je Tdrphonc
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