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Homestead_Cullivan
ea ; CLAIM FOR HOMESTEAD PROPERTY TAX* z CREDIT /STANDARD DEDUCTION State Form 5473 (R215 -92) INSTRUCTIONS: See reverse side for filing instructions. 1 r is e) — __ c y that r 1 1 y of c. 'f) occupied as our principal place of residence the fallowing described real property for which a•Home pgrty.. _ dif is hereby aimed: r.r 1 " I (We) owned ❑ Are buying under contract ❑ Have 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. CONTRACT RECORDED _ - II buying on contract, Fee Simple owner's name - Recorder's office where contract is recorded Record number Page ' PROPERTY DESCRIPTION County Township Taxing district (city. town, township) Parcel m�^�ber ©� - a� Legal tlescription �tJ�J- aS - -1 -ll ,3asl c It any portion of the residential structure or the land not exceeding one (1) aae that immediately surrounds that structure is used to produce income. describe the use and portion of/ the utilized to produce income.? yepproperty /' E-2 PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES County Township - County Township 1reby certify the above statements are true, correct and complete. S' ture Pf claimant Address (number and street, city, state. ZIP code) ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL VALUE Land not exceeding 1 (one) acre immediately surrounding residential improvements. (1) Signature of Auditor - Other land (2) Total land (line I plus line 2) (3) Residential improvements Dwelling (4) Garage (5) Other improvements (6) Total improvements (line 4 through line 6) (7) - Total value (line 3 pUs line 7) (6) 1 hereby certify the above is true, correct. and complete. Signature of Assessor Date signed Verifying action - Signature of Auditor Date signed STANDARD DEDUCTION ALLOWANCE - 19_Pay 19_ Lesser of 12 Homestead Valuation or 52,000 S Signature of Auditor D - igned �� Q.tt 1 1011,1535N.113/,-10J TR:ASU tSR HMY ISIA l .PPIMElt BY lE 3O1111:fF A((I.NtCDw rRIABIBED011111.OtrAP1.Y@TOF LOCALCO\FA)ILll NANCE IC e-1.142J , Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS . 101 N.Main Street Individuals and married couples ale limited to one homes:rad standard deduction.As the receipt of this deduction becomes Princeton. IN 47670 more beneficial.there is more incentive than ewer for homestead fraud.Homestead fraud causes higher tax bills for all:therefore. .v ° II EA 1344?009 requires taxpayen who receive the homestead standard deduction to verify that they are eligible to receive the FILED Myth and to pr(widc additional identifying information necessary to allow county government st t to better monitor homeead filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of local Goren-menl Finance will use this information to creak tool:;hat will help county officials eliminate homestead baud. • ' PART I: PROPERTY INFORMATION MAY 4 2012 Taxpayer Name Location Address Cullivan, David C. .n N775E FRANCISCO IN 47649 1 6t;$SON COUNTY AUDITOR David Cullivan ��I OI it II 1111.OII l 11:DII I III IID 111111 IF 1011111 11 I_I 1 11111111 OID II 111 4668 N 775 E FRANCISCO IN 47649-9287 1111111"III11'IIIIlllltIIIllflltlllllIllIl'IIIIII'lll'llI"'III' State Parcel Number Legal Description 26-06-16-200-000.694-017 PT S 16-1-9 23.00 AC C-1 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, ______ ses- . _-.. __—____-_.___.PART2:-TAXPAYER INFORMATION.__.- __.-_ —.- .er I First Middle Last w e3_ ) I �-ee (Lf A V Mailing Address(number and street.city,state,and ZIP code) ere as properly address t/66g 7758 Spouse First Middle cAdf, Last Mailing Address(Number and street.city,state,and ZIP code) [j31 rte as property address 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. Ow SiEnature � / Date 7 PART 4:ADDITIONAL INFORMATION 0