Homestead_Griswold�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
PAFYAIpmPY i11F
*xr..suFCnrox�:su
Individuals anJ marriN mupl� are limited �o onc home9caJ �tznAaN dMu.iion. As the rcrcipt ot �hi> deduclion 6ttame_
more benenciai, there is morc incen:ne than e�er for M1omestead frawi Ilomotrad f�aud auses highrr uc bill> for all; ihertfae.
H!A 13J-�'009 requim uiparen who recei.e thc hoinesceaJ s�andarJ JeAuciion w reri(y dut they are eli�iNe to mcene the
beneFt and ro p�a�ide azWitio�l idrnni�'im: infwmar,on ncm-vn to allw' counn� ewemmm� ro W.ter mwfmr IwmrneaJ
filirq�. This inlormatinn will M{,ryv mn11i1rntiai anA can only le araecsnl 6y authorisl rnunty nfT¢ia1s. The Ik�unmm�� nf
I.ocal Gmemmem Pinam�c will uxc �his iniortnation m crcam twls �ha� will h:lp cwnry uffieial. dimiiarc Iwmestwd fraud.
651
Earl L Griswald
R3Box10 ���"i$ t-TqFTOtON�D
PRINCETON IN 47670-8603
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Tasoarer Name Proprrtc Address
Griswold, Earl L/Mary Belh �
\ / R3 f3or 10 A
�z i Princcian I\;7670
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State Parcel NumAer Leeal Description
2G12-OS-400-003.153-027 006-031530o PT SE 5 210 7.75 AC
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This form MUST be retumed to County Auditor's office.
Please do NOT send this form back with your tax payment to the county tlreasurer.
' f�t V� ��1
Addras (number ond sam. cirv, scatc, and ZIP codc)
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L � t.
2_
Numbcr (lut 5 digi
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I C�r isw old
�emc as propem addres�
l �,O
� Oihcr (plcuc spccif in Pan 4 bclow�) '
Middle �
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���,� P�o�m �aare� '
�VYr�CP� S� U-1.��
O�hcr (plase spccify in Part 4 bclow) �
�dersicned certifies, under penalry of pepury, that the abovz and foregoing infortnaeion is true and corrzct and that he or she is elieible to
the homestead standard deduction on this property. Each undersigned alio underslands that, by claimin� additional homestead deductions
dly, he or she may be liable for back taxes and substantial financial penalties. �
SiEmanuc Dnm Tclephonc �
�.� �a�. .%�n.�,�.,n,-P�% -�����io (
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(��� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� / Siale Form 5173 (R614-03)
Prescribed by the Depanmem ol Local Govemment Finance
INSTRUCTIONS: See revcrsc sfde loi lilinq lnsVUCfinns.
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�:� i ,n, .,� �E:• . . ._,.- =,-� . -.. ..�er��....�
FORM YEAR
HC10
I(VJe) certify�(pn,th, 1�� of March, 20
I(We) occupied as our principal place o( residence Ihe following described real property for which a Homestead operty Tac i is hereby daimed:
❑ I(We) owned ❑ Are buying under contracl �
I/
� Have a benefidal interest in lhe eniiry that is liable for the property taxes on the property and Ihat ow�;the.pcop�y � , contract.
II buying on contrad, Fee Simple ownefs name
Remrdels olfice where contrad is remrded
II any
ot �he
Record number � Page
Tavnship Tacing di5lrid t ow P)
�Q
/�� Le9al descripti0n Is Ne prope i question:
'-L.�J Real D�oVertY ❑ h7obile Homo (/.C. 67.1-7)
:iAential strucWre or the land not exceeding one (1) acre t�at immediately surrounds �hat sWCture is usetl b produce income, tlesaiba the use antl ponion
to produce inwme.
iF:s�,.<=''•:;°rr� -`=s:`s? . -;i�°BROPERTY:OWNED�BYCLAIMANT
..ounty Tawnship County
I hereby ceNfy Ihe above statements are W e, corred and complete.
�ddjf�s (ryrtfbe��nU sf�ee�ry, sfate, ZIP cotle) fj , �_ _
To.vnship
i
3`� �x�C i��'' ASSESSDRUSEONLY...; ��..TRUETAX ASSESSEDVALUE 'HOMESTEAD-- NONcRESIDENTIAC.
:_r',. `+ir� zl � ._,,:.:.. £ . -. :-+" . . � � � • ' ' VALUE .. .. AT 700 /e:OFTTV -_-- ` VALUE • ..=- .., � . ; . , VALUE �.. - " •:.�.
Land not exceeding 1(one) acre immediately -�� - . �
surrounding resi0ential improvements. ��� . - � I
Otherland �2) � . _ �
Tatal land (line 7 plus line 2) (3�
Dwelling (4) . .;_ ' .
ResidenlielimprovemanLSorAnnually 4.`�..;';`-I,H,.�l: _"°. _ -
Pssesseei Mobile I Manufaclured Home Garage (5� - .
Other improvements (6)
Total improvements (line 4 through line 6) (7� �
�al value (line 3 plus line n (g�
ereby certify �he above is We, covect, and Signaeure ornsseswr Date signed
complele.
Venlying actbn - Signature oflwditor Date sgnetl
- �`"'-!;:-�-� �� =�--STANDARDDEUl1CTI0N
20 _ Pay 20 _
Lesserof V2 Homes;ead
vauauon or 535.000
S
A J, � I Date sign �
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