HomeMy WebLinkAboutHomestead_FarrowCLAIM FOR H I OMESTEAD PROPERTY TAX FORM
YEAR
CREDIT /STANDARD DEDUCTION' HC10
State Form 5473 (R614-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
I (we) I 2N NA MU11,LZ \. - -lu I'LIA M & - ) certify that on the tat day of,March, 20
1 (We) occupiA as our principal place of residence the following described real property for which a Homestead Property Tax Credit Is hereby claimed:
I (We) owned ❑ Are buying under contract
Wave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
- I -, -j- _ - , - - , '- -7
ONTRACTiRECORDED,
If buying on contract. Fee Simple owners name
Recordees office whom contract is recorded Record number Page
tMiRl' 4?-� PROPERT� DESCRIPTION. ';.L
County
Tamu;h p
Taxing d ' lady, town, township)
Parcel number
LegfIdescription Is the property In question:
Signature of claimant
❑
Ail property CJ Mobile Home (LC. 6-1.1-7)
n-
If any portion of the residential structure or the land not exceeding me (I cre that immediately surrounds the M a used to produce inoxne, describe the use and portion
of the property utilized to produce income. I L4 oc T1 t) F
02; -/3 /eq 3 - eoe'v- ':3,3clo —
OROPERT,.Y'OWNE]j'6Y-CLAIMANT41WOTHEFt-COUNTIESk'T i�,-Z.' I
County
Tmmshfp
County
Tovnship
I hereby certify the above statements are true, correct and complete.
Signature of claimant
W(number and $"at, City, state, ZIP code)
STANDARD DEDUCTION ALLOWANCE-
1,,+ TRUE XAV ?V
ASSESSED VALUE
'-` HOMESTEAD ,
M NON RESIDENTIAL' ,-,
S
0"ATAI00 OO
?-,*VALUE
Signature of Auditor
Date
_,Q(3 ,
!
Land not exceeding I (one) acre'immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
g,
Residential improvements or Annually
Assessed Mobile I Manufactured Home
n
Garage
(5)
O Iiiei improvements
(6)
Tctal improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correa and
Signature of Assessor
Date signed
complete.
verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE-
20_Pay2O_
Lesser of 12 Homestead
S
Valuation or 535,000
a
Signature of Auditor
Date
_,Q(3 ,
STATE FORM 533M in I Sat.). TPFAnJtf)l FORM 73-IA
APIXT'En By snit ens.AD .Ares Resr'.Zino PILMUBmnY MT DEPMMCfr(r LOCAL nwrRAMTM FINANCE IeFI.I-2:4.I
0 Nn County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
_ more beneficial.there is more incentne than e'er for homestead fraud_homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verily than they are eligible to teethe the
benefit and to provide additional identifyirc_ informaton necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only he arressed by authnrbnd county officials.The Ikpannant of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Farrow, Karen D yob 5-.b,uislo.a sf
..111-I36.4?e
Francisco IN 47649
4622
Karen D Farrow
408 S Division St State Parcel Number Legal Description
FRANCISCO IN 47649-9788_ _.
1r 1rr11rrr1r11rrr1rE11r1rr1tlrtlrtt ilrrlt�tt ltlltttlt tirilrrrl 26-13-20-103-000.336-005 012-00336-000W&M ADD 14 PT/15 PT
PART 2:TAXPAYER INFORMATION a
Owner I First' Middle Last
kE ✓ 17 AA/g yA/a AO a)
�g Address(number and street.city,state,and ZIP code) Same as property address _ - - ---
110P 5. .�It"sto.v sr. r,enA/e/seo, / /f 4176 y9
Spouse First '/ Middle Lag
(NAVNE 1 ek.m17 I /12R. Go
Mailing Address(Number and street,city,state,and ZIP code) ®Same as property address
le 08 S. D,ws/DA) Sr, feyvCiSeo, /N z176 49 --
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury.that the above and foregoing information is true and correct and that he or she is eligible to
receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he or she may be liable for back taxes and substantial financial penalties.
Owner I Si attire Date
) ��
PART 4:ADDITIONAL INFORMATION
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