HomeMy WebLinkAboutHomestead_CochranCLAIM FOR HOMESTEAD PROPERTY TAX G FORM YEAR
CREDITIST/WDARD DEDUCTION � Hcto
SIaM fam 5473 (RB / 1-03) �
ResaiDed Ey tAe DepeNront d Luai Government Finanoe
INSTRUCTiONS: See re��roo aWa IFr �Erp itabuUiono,
�'�':- �>..�. :.^:� '-'� °�r :w-�� -c ��rt�;� -7�:CER1'IFICAl10N�5T MENT`' ' � �1��� �:'__� �v . ,��y''., ,�,y�:? -s:'�'-t.:^�'-'
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��e) t b�m�e s�ay of March, 20_
I(We) occupied as our prin i I place ot residence the following described real property for which a Homestead Pro eAy Fac redJ ys hereby daimed:
❑ I(We) owned ❑ e buying under contract S� P L� � V�o
Have a benefidal interest in ihe entity that is liable (ar ihe property taxes on the property and that owns the
If buying on conVad, Fee Simple ownets name
Recorders ofice where contraa is recoreed
T��v
legal tlexription
perty or is buying under a wntract.
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�= `.T °tr'�a'`a�i�{�-�,"�az'�.�-3��..'-s^
Record number Page
Is Ihe property in quesUon: �
�eal vmperty ❑ Mobile Homo p.C. 67. f-�
i( any poAion a/ Ne residantlal sW cture w the Wnd na exceeding one (t ) aae that immediatey wrrounds Ihat swcture is used to produce income, desaiba 1he use and portbn
of the prop rty uGl¢ed tn protluce income.
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�.'�i ". �� �i''-'�-'F X"`°.•T�'!�.i�.�,' "" "�- . ' «"L . . . °_ . . *- • . ^p- _ t
��3ASSESSOR��USE ONLY ��'`s'�'�"`�� � TRUETAX -s . ASSESSED VALUE y,�HO1dESTEAD^�' NONitE51UENTIAL �
;��yA�,��.�„�� �;r.��..n�;;p��� � �„�V/LLUE�..u''"�� .�AT 700%OFTTY� ���ySy,VALUE��'�.'4 ��_„��''�S�VALUE��'�
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Land not exceeding 7(one) aae immediately �t�°.q`g. �;,=!:�"�iz.iz.�'��-�- �
sunounding residential improvemenis. (� � -'����" yi',-� � �� �,�=:£<
Other land (Z) � "� ` � �� � �
�3�'.� v�� �,z
Total land (line 1 plus line 2) (3)
"S f"'.{ GS 3rd�' �h T-�'_�
Dwelling (4) -�t# �' c�'��i �"'�
� ��$��u'�.rr.a�'X€�,3'�x�
RMaeaeed AAobBe / emen��nHuaOy� Gara e '��"�` �` a.,.f,.�r^z:y�.
9 (5) ����b�����3
{ �S`y
Other improvements (6) �;?� ��
�o wi u. �
Total improvements (line 4 fhrough line 6) (�)
TUaI value (line 3 plts line � (g)
I hereby certify fhe above is W e, mned, and Signature o(nsseuor oate signee
complete.
Verilying actbn - Signature of Autlimr Date sgned
20 _ Pay 20 _
Lesser of 12 Homestead
vauabon a 535.000
�► . �
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Gibson Counry Audilor
107 N. Main SUeet
Princeton, IN 47670
1421
Sf�TEfORM:lSW
lOW
P0.ESCM1IBIDBYTIIE
TYFASLTE0.I00.MTS1�
Individuals and married couplcs are limired m one homcscead standanl deductioa As the receipt of thi: daluccion he�romes
more brneficial, �here is morc inccntire Ilw� tt�er (or homestead fraud. Homestead Caud muses highcr Iac bills for all; [herefore,
HEA 134»-?009'cqnires Iaxpayers wip recenc Ihe homestcad standard deduction to �xrify tAat thcy arc eligib�e [o recene Ihe
brnc(1 and to proridc additimul idrntifiing in(ormauan nccessary b allow' county ga�emmcct to hetfer monimr ho:natwd
filin�s. This information aill h kept con6drn[ial and can onty be acccsscd W aut6orizcd county afficiaLc. The Depanmrni oF
Tyrone C Cochran
3005 S 275 E
PRINCETON W 47670-8734
����i���dil�lhl�i�il�ihnn��i�n�illl��luun�i�„i�i�nnll
Taxoaver Name
Cochran, Tyrone GShellia D `
/ `
I Il�l�lll�ulll �III�I �III
LocationAddress .
3005 S 275 E
PRINCETON IN 47670
II� II I�II �I� I I� III I� �II� II�I �I� II IIII
State Parcel Number Leqal Descriution
26-12-27-300-001.478-02�w sw 27-2-70 2.0o nC o-io
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.
C hri�-h��
nddress (dumbcr and stree4 ciTy, statc end ZIP codc)
3eu� 5 � �,��� � 'Pnhw-I�, -
ecuriry N�bcr (last 5 digits) Drivcli Liccnsd5tate ID Number (lazt 5 diAa)
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Number (lazt S digits) D��
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acnse/State m Numbcr (lazt 5
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Same as propeny address .
Othcr (pleau specify in Part 4 bclow)
Swe
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`S+Jame ss property address �— � - ; —
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Other (pleasc specify in Pert 4 bclow) �
undersigned certifies, under penalty of pequry; ihat the above and foregoing infortnation is true and cortect and tha[ he or she is eligible to
+e the homestead standazd deduction on this property. Each undersigned also undecstands that, by claiming addirional homestead deducrions
�fully, he or she may be liable for back taxes and substaotial fmancial penalties. __
� I Sigianue . , Date Telephone .
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