Homestead_Gardner (5).�•_��,, CLAIM FOR HOMESTEAD PROPERTY TAX • FoRM YEAR
d�, � .. . . _ .
�� y: CREDIT/STANDARD DEDUCTION Hc�o �2
� � State Form 5473 (R2/1-90)
�' '°�• �� INSTRUCTIONS: See reverse. side for filing instructions. . ,
CERTIFICATION STATEMENT
I(WaL�l�,,_/�' � y'�,,� /1� �,
�Gl�- �( � 0'/�`�'� e i y that on the 1st day of March , 19�
We o cu ied as our rinci al lace of residence the fol n described real ro ert for which a Homestead
I' ( ) P P P P 9 P P Y
Property Tax Credit is hereby claimed: I(We) owned ❑ Are buying under contract
� Have a beneficial interest in the entity that is liable for the property taxes on th
property or is buying it under a contract.
CONTRACT RECORDED
If buying on contract. Fee Simple Owner's Name
Recorder.'s office where contract
PROPERTY DESCR
Legal
and that owns the
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER
hereby certify the above siatements are true, correct and
mber,
ASSESSOR USE ONLY �
siate an�IP code)
ES
TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding 1(one) acre'immediately ��
surrounding residential improvements ��)
Oiherland (2)
Total land - line (7) plus line (2) (3)
Residentiafimprovements Dwelling (4) - - -- -- � -
Garage (5)
Oiher improvements (6)
Total improvements - line (4) through line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify ihe above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
STANDARD DEDUCTION ALLOWANCE
.
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Gibsan County Auditor
101 N Main
PRINCETON IN 47670
4164
iIAIE f00..4!RM Iti l .W"1
1PfAC11AERf4.lV�SU
IndiriJuaL. anJ ma:riN coupk. arc limi�td w nnc hnme�tead aandaN �Junion. As �he recript nl Ihu Jeduc�imn becanes
morc beneficial. �herc is mwe incrntne dun ner for homesteacl fraud. Homr�xacl naml causa higher h� bills (or all; thercfore.
NEA 133i-201l9 require� taiparen who reccivc ihc hanestcad standard deAunion �u rerity ilut tM1cy are �eligiMe lo reaene tAe
bmefit ani ro pmcid< addiiio�ul idenuirim� in(urmatiun nea:�vey to allw� counn� go��rmmrnt ro ben:r moniror Mmesread
filin�,�.'Itiis inlormmim xill M Aryv mnfdeNial anA c�n nNy h avre� d by autMrizrd rowly nOkia�s. The Ikpannrent nf
1_oeal Gwemmem FiwM< ��ill u.e this in(o�mation W crcah twls �hat x'ill hdn camn' olTieial. elimiurc homatead fiaud.
T��naver Name
Gardner. Jackie S/ Marla S
Jackie S/Marla S Gardner
1398 E 425 S
Princeton IN 4767Q9235
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Princctnn 1\i;7670 �� 5
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State Parcel Number Le?al Descriotion
26-12-32-400-002.131-027�— OOCi-02137-M PT-NE SE 32 2 7P 3.00AC-- -
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Oauer 1 First AfidNe � LaU
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ig Address (numbcr and svicet. city, statc, and ZIP cadc) �j�'Snme as propem oddress -� �
! 3S � C -�fas S' t�- �'�nce`fon 2n . �/�67d - -- I
Social Securiiy Numba (last 5 diciu) Uriver's License/Staie ID Nmnbcr (13.� 5 digiB) O�her (plc�se specify in Part 4 bclow) �
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Spou;e First � Middlc ^ � Last
yQrelner'
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1345t � �fa5 S Pr�r��,��n �w. �767� �
Social� u��umbcr
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Fach undersigned cenifies, undzr penalty of �rjuq�, that the above and foregoing infoRnation is we and correct and that he or stie is elieible to
receive the homestead standard deduciion on this property. Fach undersi¢ned al;o understands that, by claiming additional homestead deductions
unlaw�fully, he or she may be liable for back taxes and substantial financial penalties. �
O�.ov I Sibmana ,y Dat� 1'cicphmc �
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