Homestead_Firkins, CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
/ Sia�e Fwm 5473 (Rfi / 4-03)
Prescn6ed by the DeparUnent ol Lacal Govemment Finance
INSTRUCTIONS: See reversc side Ior /iliny lnsfiuclinns.
��� YEAR
�C�
NOV 18 2004
/ '
� M�e) certify Iha�%k�11s'1C2� �.
I(We) upied as our principal place of sidence the lowing described real property for which a Homestead Property Tac Credit is hereby daimed:
(We) owned ❑ Are buyirg under contract �
Nave a benefidal interest in lhe enfity that is liable for the property taxes on the property and that owns the property or is buying under a conVact.
il huying on co�Vact, Fee Simple owners name
Remrdels olfice where conVact is recorded
County
Toxnship
If any porlion of the resitlential sWCWre w the
ol the property utilaed to produce income.
l�.g�f
one (1) ave thaljmn
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Tating tlislrict
Rewrd number � Page
�erty in queslion: '
❑ Real properry ❑ Mobila Homo (I.C. 6f.7-�
sWGUre is useC b produce income, desvibe Na use and portion
20 _ Pay 20 _
Lesser W 1/2 Homes:ead
vauaum or 835.OW
5
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lRFASL'RFRi00.MTS1A
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Gibson CounryAuditor � � � O � / 1 ' • • ' i
101 N. Main Street Individuals and married rouples are limited ro ane hommead standard deduction. As che rtceipt of this deduction hecoma
PfIfIC0tOf1, IN 47670 more brneficial, ihcrc is more inccntive itwi cvcr for homatcad (mud Homesicad Gaud causes higAe: taz bills for all; �here(ore,
� T�� T HEA 134C-?009 tcquves uxp�rn wiro cecerv< Ihc homestcad siandard dcduciion to �crify thal thn% art cligiblc ro recei�x Ihc
1 � a bcnefit and to prrnide addiuonai idrnufying informelion nttessarv to allow' county grnsmmect t�bener momwr homestend
Lfiling. This informuion aill bc tept wnfidrncial and can onW be acc.°ssM by auc6orvzd caunty a;Lcials. Thc D�qarmicm of
I.ocal Grn�emmmt Finance will uu ihis inPortnation m crtate tools that will helo munri officials elimifute Iwmesttad faud.
' MAY 11 2011
C�.n " V
GIBSON COUNTY AUDITOR
1441
Daniel E Firkins
4652 W SR 64
PRINCETON IN 47670
Taxaaver Name
Firkins, Daniel E/Jennifer S
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II�I�III��III �II �I OII
0 SR fKl
PRINCETON IN 47670
II�II�III�I�II�l�llllulll (I I�I� II II
State Parcel Number Leqal Drscription
I
26-11-08-200-000.623-02�PT SE NE 8 211 3.4 �8 AC D-1
This form MUST be returned to County Auditor's office. I
Please do NOT send this form back with your tax payment to the couniy treasurer.
.�.�� ea � �
ling Addxest (mnnbcr and street, city, statc, and Z[P tode)
y�S a� Q-s� .S-I�� Q��. l��
ial Securitv \�rmher (last 5 dieiL.l Driver's LicrnsdStau [D Numbn
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z-.r�.�cf — ----I- — ��,�-
Address (Number and streeC city, statc, and 7.IP code)
Number (lact 5
ID Number (last 5 digits)
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Same as property address
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Other (pleau spaify in Part
] Sme
diddle
�r�.�S
� $amc a pmperty add�ess
O�hn (plcau tpacify in Part
undersigned certifies, under penalry of perjury, ihat the above and foregoing infortna[ion is we and correci and Uiat h� or she is �
+e the homestead standard deduction on this property. Each undenigned also understands [hat, by claiming additional homestead
�fully, he orS�e m� be liable for 6ack taxes and substanual 6nancial penalties. �
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