HomeMy WebLinkAboutHomestead_Cowingt�%��; CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Slate Form 5173 (R61403)
Presvi6ed by �he Department of Local Govemment Finance
INSTRUCTIONS: See revcrse sidc lor lilinq insfiuchonti.
�'d�:?j�i,i:;i::A::::^„-'�.:^:Ya-°5:r'_-.. .. .. f ---;;....: .. . rconnrwr
� �e� certif
I(We) occupied as our prin al place of residence Ihe follo ' g described real property for which a s�e
❑ i(We) owned ❑ We buying under contracl
� Have a beneficiaf interesl in the entity that is liable for the properry taxes on the properry and that owns Ihe
1''(
FORM � YEAR
HC10
the tsl da of March, 20
� C dit hereby daimed:
� '
��
or is buying untler a contract.
Caunry . �_ Tavnship_.
r I umher L description
G.�o4a�-c� �P'�,�.° �
I( any portion ot the resitlential sWCWre w the land not exceedi
of Ne properry utilizetl to produce income.
- '�'�PROPERTYDESCRIP.TION?.� � •-�•- � ' -- � �� z'�-` � �
Tacing tlistritt (ury, (owq township)
4 I Is ihe properry in question
�r ❑ Real property ❑ Mabile Homo Q.Q biJ-7)
one (1) acre ihat immetlialely surmunds Ihat swcture is usetl to D��uce inwme, desuibe Ne use and portion
J}�� �� 4�'} ASSESSOR USE ONLY TRUE TAX � ASSESSED VALUE � HOMESTEAD� � NON-RESIDENTIAC,
-p'?"• y `� •. . .•� VALUE � AT700%OF_TTV_ .,'. , VALUE, `ii• - `��'rVALUE�".
.,sn-4e�- : .. F <-.�,.--s .- � ..
^Land not exceeding 1 (one) acre immediately -' - ' - � �` i':
surrounding resitlential improvements ��) . .. � ' � `
Other�and �z) �- _ �
TRaI land (line 7 plus line 2) (3)
�J ..
Dwelling (4) . ,.,tg;'::!'':.:�:::Fe;,=.x+=�; �''''�
Residentiel improvemants orMnualty
0.ssessed Mobile I Manufactured Home Garage (5) `��"r� .:`' -
Olher improvements (6) I �- �
TUaI improvements (line 4 through line 6) I(7)
Tctal value (line 3 phs line n (g�
I hereby certify the above is W e, cortect, and Signawre or wssessor Da�e signed
complete.
Vaitying aclion - Signature of FwUitor Dale signed .
---_- � -� = �STANOARD.
20 _ Pay 20 _
Lesser o� 1/2 Homes;ead
vauauon or 535.000
Sgnature of Auditw
5
�a�.�suwn roxu rsu
. GibsonCountyAuditor � � � � � � • � � � � � � �
701 N. Mafn Stre2t IndiriJua6 and rturried coupla are IimitN [o ont honksead zianduJ d�yluctiun. A> �he raeipt ol :hi> Jnluctiun 6ecnme>
Prineeton, IN 47670 more ben<ftcul. ihen fs rtrorc ir,crnti�c �han eccr liir hom;>tuhd Gaud. !lu�ne�tcad (nW cauas Sicher us bill: lor all: �h�rrior..
• IIEA 13Ji-101W reyuir.�s �a�pacrn uhn rm:ive [he home.tead uanJartl Aeduc[ian �o �eri(y �hat ihey arc eligihle �o nceive �M1e
�!� � bcnclii anJ m prrnidc akfi�inn�l idcntifying ir,tbrmaiion nc:csvn� io alhM� coumv eoccmmcm in 6n�tt nkmiiar han�,cacaJ
1 n,c Ihi in(ornu�im xill M Aryw eonfWrn�ial and c�n onk be a-�r..rd b. autMxizaf counn oflicu6. The Dapmmer.� uf
I Gm�crr.r.wm Financc ��ill ux. thi. in(ortnuion tn cr�tc trols :hai will hclp ronnrv ofTaul> climimir hometcad (nuJ.
;�� c r i. �;� . �
APR 19 2012
c�.m�
19�3 GIBSONCOUNTYAUDITOR
Shirley F Cowing
536 S Pineview Dr
PRINCETON IN 47670-8134
Illiniui�ii�li�lu��nl�i�rll��nu�y���i����iy���illlhii�i
TaxpaverName LocationAddress
Cowing, Shirley F
536 S PINEVIEW DR
PRINCETON IN 47670
I��III QI�II�II�011�11�11�11101�I�111�1 I��II�II�I�I� II II
State Parcel Number Leaal Descriation
2G71-1S100-004.265-027 PINEViEW4
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.
!�er 1
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Addtess (numbe� and sv
6 ,s. /��,vP
, ciiy, sta[e, and LIP codc)
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Addrtss (�umCer md s:rcet ciq�, stale, and %I P code)
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��ri /✓� L�v�l/
fD.�`umlxr Qu:Sdiei�)
Numbcr Qas� i diei�sl I Unrds Limnscl5tatt ID Vumber
C o cU� ; N
Same us propeny add.-ess
�f 7�Othn (Glns so=rifi• ir.
� Same as propeny add:ess
Suk
O�her (please spec:fy ir. Pan a below)
mdersiened ce�i6es, under penalty of perjury, that the abo��e and foregoing inlormation is true and correct and that hz or she is zligible to
e the homestead standard deduction on this property. Fach undersieneel also understands that, by clzimine additiun�l homestead deductions
fully, he or she may be liable for back taxes and substantial financial penalties.
� 9i�enut � Dare Telephune
�w 3'. �� 'f-l3-iz ��/
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