HomeMy WebLinkAboutHomestead_CapehartCLAIM FOR HOMESTEAD PROPERTYTAX
CREDIT/STANDARD DEDUCTION
Staie Form 5473 (R6 / 4-03)
Prasaibed by the DepaRment W Locat Govemment Financa
WSTRUC710N5: See 2verse side lor filing inshuctipns.
FORM 1 YEAR
HC70
�(We� w:�%� � certi�op th�lL,'(,� of March, 20
I(We) occupied as our principal place of residence the following described al property for which a Homestea eriy 61� is hereby daimed:
❑ I(We) owned ❑ Are buying under coniract
' Have a benefidal interest in Ihe en6ty Nat is liable for the property taxes on ihe property and that owns the ro er�po��g under a wntract.
If buying on wntrad, Fee Simple ownefs name
Retordefs affice where conVacl is recor0ed
�-'-i °M'—'—."S t.��'�`�z���.c��':'r'.�t �.��-SSw
Caunty Tomship
P u ber Legalde!
�, -n4n.CC.n�, mr
ol lhe resitlentia� sWCture w the land nW exceetling one (1) aae ihat
y utiaed tn produce inmma.
Record number
Tating districl (ciry, rown,
Page
, Is ihe property in question:
� � Real property ❑ Moblle Nomo (I.C. 67.1-7)
sunounds Nat swcture is used to produce income, desvi6e Ihe use antl portion
��4��a�@'.SS�'�= ±�.�Ir1'-'a�. z:z�*�4�,;i�.'-`t-`'-a�`K�-,���x��STANDARU�:DEDUCTION'ALCOMIANCE � �n� ��,:;=�,�'9'^�[: s� i' "h-
- .'F �_'+�_`�'`�fs cs�i`��.r
20_Pay20_
Lesser of 1r2 Homestead
VeluaUOn W E35.000 S
SignaWre otAUditor " Date signed
•
Gibson County Auditor
101 N Main
PRINCETON IN 47670
u
1859
liilE {IIRN �l.M IIC'/4M1
.
MAA:RFJI f00.411.�
InJiviJual.. anJ marrieJ couplc.. arc Iimilni �o rn�c hnmcacaJ uandaN Jnlunion. As ihe reccip� of �his dcdunion becomce
morc beneficial, thrrc is morc incenme than e�er for honx>rca�l frdud. Homea�eael feuul cau.sa hi�her tax bflls for all; therefae.
HHA 133;-?fMW requ"ves uapa.crs xho recei.�e tM hanesteaJ sundard �4aluction m v.rily tfut ehey are dieiMe io meei.e ihe
benefii aN tu pnr'id< :xhliuunal iJentiirinc fnWrma�iun mces-vn ro allw� counp� gv.'rmmmi ro bener mwiror homrse:x7
Iiii��.. This inlnmuiion will M1e Aery cmfidrniial anA can onl�� h• acce. uJ M1r amMrirni ronnn� Mlicial..'Ihe Ikpannmm nl
laical Gm'crnnem Fi�um'e ��ill uae this intormation tu cr<a:c [uuls ihat aiU hcln �ountv ufI'iciaL. elimi�m homc>�eaJ tmud.
Randall L/ Sarah L Capehart \
3298 W Mary Roberts Dr
Princeton IN 47670-8472 �
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Taxpa��er Nrme
irt. Randal� L/ Sarah L
' State Parcel NumAer
2611-15-100-00,4.055-027
/
N
,�o I I — a I LoU�S I
duress (number un6 i¢m: iry. stme: anOZiP code) ' — -' — —' - — - - ' ^ "�
3Z98 I.✓ /tiar� /Z�ei`�3 .1�� D�Ih�oH ��/
urily Yumba Qast 5 dicils) Dmers Lice2�c/5taie IU Numba Qaz� 5 digiLS) Othe� (pleaze sp
/
Sq�4�+ I L�rn
e.4ddress (�umber anJ svtt4 ciry�, siaie, nnd "LIP coJe)
329p l✓ /y4� /1odxF�s.lJr P/�.�<
Security NumMr (lut 5 dieirs) Drivcrs' Licensc/S�atc ID Nianbcr �lau 5
� $ame
�
Prnpem� Address
R3 I3oz i30
Prince�an f\ 37670
Leeal Descriotion
006-04055-00 M C ROBERTS TICHENOR
RD PHASE II 2
Q f"�
a;'w.�. _"_ __— _ —
Ca
undersieneJ certi6es, under penalN o( pequry•, that the abo��e and foregoino in(urtnation is we and cortect and that he or she is elieible to
:e the homes�ead siandard deduction on this property. Each undersigned al;o understands tha�, by claiming additional homestead deductions
�rfully, he or she may be liable for 6ack taxes and subsiantial financial penalties.
� I Siymanuc Uatc l'cicphonc
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