HomeMy WebLinkAboutHomestead_McClurkin STATE FORM 53569 00/&I4) TREASURER RAM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,Wi PRESCRIBID BY THE DEPARTMENT OF IMALOOVLR\MEYr FINANCEIC 61.I-U.2.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS..
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
Princeton.IN 47670 more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
F I benefit and to provide additional identifying information necessary allow county government to better monitor homestead
®, filings.This information will be kept confidential and can only be officials.accessed by authorized county ocials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION •.. . -
APR 18'2011 Taxpayer Name Location Address
•C.�.0 McClurkin, Judith C..."./
305 N Seminary
GIBSON COUNTY AUDITOR ' Princeton IN 47670
770 I II II ., npl II
Judith C McClurkin IIDI�III_DIII�II�I ullull III �IIIOI IIII�DII�IIIII_IIIDI_III I�IIID�IIDIIlIOII In II
305 N Seminary
PRINCETON IN 47670-1829
IIII'llllllllll'lllll'll'IIt III'ItIIItI,ISIIIIIIttIItltllllltlttl State Parcel Number Legal Description
26-12-07-203-000A99-028 /OLD PLAN 59 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. -
- A' _: A. 'A ' - 1 's A S.
01.DC I First /� Middle - Last
JLtei /fh 0ure! - eClu / kIA
Mailing Address(number and street,city,state,and ZIP code) - qg Same as property address a
/ _
Spouse - First Middle - Last
Nona,
Matim_Add:�s Number and street,city,state andZti d) _ - '.n... _-^-0-Same as property address—T'-""-^°'—'z- "'^-'
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below) `
' I 1 I I I I i Size
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 1 Signature Date
•
n.
� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fwm 5473 (RB / 4-03)
PreSaibed by Ne Department of Local Govemment Finance
INSTRUCTIONS: See reverse side /oi liling inslmcifons.
FORM YEAR
HC10
I(We) / ��W certi � that on the 1st day of Marfh, 20
I(We) occupied as our principal place o( residence th ollowing described real property for which a Homestead�pe�rt�-��� Cre t's he��d� em d
J
❑ I(VJe) owned ❑ Are buying under contract � GIBSOiJ COUNTY AUDITOR
� Have a benefidal interest in the enGty that is liable (or ihe property taxes on ihe property and Uiat owns the property or is buying under a wntraU.
11 byMg on ca�Vaq, Fee Simple owners name
Recorders olfica whrse
Tamship
. a.�.,� -� �/g 9-� .
i( any ponion ol the residentiel sW cWra w 1he
of tha property utiiized to produce income.
Record number � Page
Tacing district (ciry,
Is the
E'if.(/►� Ji f!— 7 � Lj�!R�� v�o,�m ❑ Mobile Homo Q.C. &f. f-n .
one (1) acre thet immediately surtounds that s Gure is used to D�oduce income, describe the use and poNon