Homestead_Collins (7)CLAIM FOR HOMESTEAD PROPERTY TAX
� . ' CREDIT/STANDARD DEDUCTION
` � State Fam 5473 (RS / 10-01)
��Y Presaibed by tha Departrnent d Local Govemment Finance
INSTRUCTIONS: See reverse side /or filing instructions.
FORM YEAR
HC10
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�(We) �, J� UIJJ 1-XI�L_� �- "�'�-/it/`i ceNty thal on the tsl day of March, 20_
,I_(W,/e) occupied as our principal place of residence ihe following described real pmperty for which a Homestead Property T�c Credit is hereby daimed:
I�_3 I(VJe) owned ❑ Ne buying under contract �
.Have a beneficial interest in ihe enfiry that is Iiable for the property taxes on Ihe property and �hat owns the properry or is buying under a wnVaG.
If buying an conVaq. Fee Simple ownefs name
County
Parcel
H any
W the
ofim whare contrad is recorded
Tawnship
Tmting
Rewrd number � Page
L al aescn iwn /� Is ihe property in question:
a� ay t� E� w �� ��\�.1 �eal DropertY ❑ Mobile Mamo (I.C. &1.1-7)
uAentlal aWaure w Me Wnd not exceedinp one (1) ace Ihat immeEiatety wrrounds lhat sWCture is used b O�duce income, desttibe the use and pwtbn
� u�oduce u�mrt�e.
�, 1oa35s
�;s>:�'"�"�.�u,'�';��,������"`zfi.Lk �.:'�'��PROP,ERTY;OWNEDTBY:��CLAIMlilIT.IN;OTHER'COUIJTIES�,�?°„".-��'���`�� �z.�"�-�„=�f:?7r'�
Counry Tavnship County Twvnship
I hereby certify the above statements are We, corred and complete. Signature o( daimant
�ss (number end sVeet, ciry, sfate, ZIP code)
-� '"���='< ��'�.3�','?£i?�?-�`�.�i°i': "RZ�:�STAN�ARD.UE_DUCTION'ALLOWANCE?�r"2'�.'a^.'.i��_3:z ..3�.'�+}5d:s�'"`��-=�'e.%��'��.�5��''+'x'�''- =�
20_Pay20_
Lesser a( tf2 Homestead
Valuatlon or $6,000 $
SignaWre of Nidilw � Date signed
l�
Gibson County Auditor
101 N. Main SVeet
Princeton, IN 47670
.�IL,ED
o APR 12 2011
C.�.tt` ��
582 v �\
GIg SONGn NTY AUDITOR
Charles Steven t;oi�ins
1345 N SR 65
PRINCETON IN 47670
TRFASI'NI. FU0.Nli1/.
Individuals and married coupla aze limited m ane homestead standard deduc[ioa As [he rmeipt of this dniuction hecomes
morc brncfrcial, thcre is mare inccntne than n�er for Mmcstead (mud. Homestrad f�aud tauses highcr tu bills for all; drcrc(orc,
HFA 1344-?009 rtquim taspayxrs aiw rccci�c Nc homcstcad standazd dcduction to �xrify iha� �6ry are eligiblc ro recei« the
brnefit and to prrnidc additional idrntifi�ing in(ormalion necessary lo flllou� mmty ga�emmrnt to bener monitar hamestead
5linss. lltis infortnation w�ll bc tept confidcntiai and can onh� bc attcssed W authorized wunry ofiicials.'1'hc Dcpartmrnt af
Local Gwxmmrnt Finance will use this in(ortnation [o crtate too� that will help counrv ofTicials elimir�a�e twmrnead faud.
' 1 1 �
Taxpaver Name Location Address
Collins, Charles Steven/Rosemarie
� / 7345 N SR 65
�
PRINCETON IN 47670
I II�I�III��III ullul �II Ilull��lll �I�II�II��II�II�II�I�II�II �II�I�II �II II�I�I�IIII III
State Parcel Number Leqal Description
26-12-06-100-002.124-027� /PT NE NW 6 2 10 4.6238 AC D-1
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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.
G'f,
Addlcss (numbcr and s¢a4 city, state, and ZIP codc)
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an� ��e� :��sy � een a
undersigned certifies, under penalty of perjury, that [he above and foregoing information is trve and correct and that he or she is eligible to
�e the homestead standard deduction on this property. Each undersigned also understands that, by claiming additional homestead deducrions
rfully, 6e or she may be liable for back tarzes and substanrial fmancial penalties. � �
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