Homestead_Hurst (9)�<n��. CLAIM FOFi HOMESTEAD PROPERTY TAX � YEAR
t/A „ a FORM
�;� , '4 CREDIT/STANDARD DEDUCTION- ' Hcio ICIRi�
:� State Form 5473 (R2/1-90) -•
'°'• � INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT. • •
I(We) �����1{/y'� I'1 •�- V.i���,� '�erti y tha on lhe 1st day of March , 19 �-
� e) occupied as our principal place of residence the following described real property for which a Homestead
roperty Tax Credit is hereby claimed: I(We) owned ❑ Are buying under contract ,
� Have a beneficial interest in the entity that is li ble for the property taxes on the property and that owns the
property or is buying it under a contract.
_ . . ��� r�i-3�\
If buying on contracL Fee
Recorder's office where contract
T
RECORDED
- A�AY 1 �: 1990
Record Number Page
PROPERTY DESCRIPTION
� �n ^ TaxingAistrict (City, town, township)
�d((1�' �O��J3--0� I _..y.�.�.,.,..��iVl-l) `�' a-�d , S�D%Q,e_ -f' , 6�7Q.�� .
If any portion of the residential structure or the land not exceeding one ( 7) acre that immediately surrounds that struc-.
ture is used to produce income describe the use and portion of the.property utilized to produce income.��
ASSESSOR USE ONLY
�
TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE
NON-RESIDENTIAL
VALUE
Landnotexceeding 7 (one)acreimmediately .
surroundinq resideniial improvements (�)
Other land (2)
' Total land - line (1) plus line (2) (3)
� _ Residential improvements . Dwelling j4) _
Garege (5)
Oiher improvements (6)
Total improvements - line (4) through line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
1989 Pay 7990
Lesser of 1/2 Homestead
Valuation or $2,500
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991 1991 Pay 1992 19 — Pay 19 —
Lesser of 7/2 Homestead Lesser of 7/2 Homestead Lesser of 1/2 Homestead
Valuation or $2.000 Vatuation or �1,500 Valuation or $1,500
Signature of Audito�� � 0 \. � ,�, A���— I��'S'ign�� '1
� ,� � ) �./j� � � CJ
�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
3374
William R/ Vera Laverne Hurst
1676 Ouler Lake RD
Princeton IN 47670
alAiEfORnI!)•e��llf�!r� � iRFASUtfRPo0.4:3-IA
n�IP[w'EbB\'ai.�RMVDOinrt�U�Ta.9Y PAfYRIBmUYIIIlOE�M1MCYf(4LfaAlCANiLV)1!A'IfY:A�('EMVI.1�4.1
hWividual> anJ ma:riN aoupks arc limi�nl io onc homcae�J �andaN 0.Nuc�ion. As the rettipt oi �hs dNunbn becomes
morc beneficial, therc fs morc incrntnx than r�er (or homesmacl fraud. Ilomra�eaJ fiaud causes higher taa oflls (or all: therefore.
HEA 133�1-NN19 cequim uapa.en aho rcecire ihc hnmest:ad sianda�J Jedunion �u .erilj� ttwi �hcy are elieiMe m mcci.c ih.
beneni anl m pnr'idc :�dli�ional iJemiiyine infumiatwn neces'vey io allw� cuunn' �n'rmmenl ro W.trer munitor honxsm:N
i
filin�,�. Ilii� infomution x�ill be Aryw emlidential anA on nnly M acmzanl hy nulhnriicA cnmu�� n(f¢ial�. The lijvnnxm of
Tacna��er Namr
Hursl, William R/ Vera Laveme
/�'�/
State Parcel Number
26-12-09-103-00/0.953-027
✓
1676 Outer Lake Rd
Princcton IR,J7670
006-00953-00 PT W IJW 9 2 10 .914 AC
1• �
Ou�ncr I / First Middle i���/�C/Lill�� Lui
V V�-� � �
ig Add� (numbcr ond suee[, cirv, sutc. and ZIP c c) .. -�' —� —'' me ffi pmperrv aadf¢i -- —
/!o %!v [Pu�et-�<- �,.�. �`��; �c - `i 7 � 7 0 —�—
Social Sccurity Numba (last 5 diei¢) Drivers Littnsd$ute ID Nmnber (lasl 5 diviu) Olhcr (pleue specify in Part 4 bclow) I
, /�'��°�
Spou'.c First Middlc ��
Mailinc Addresti (�umber and slrttl city, stele, and "LIP cu�k) �� � Same as pmpmy addre�-, I
Soeial Stturiry Numbcr (last 5 digics) Drivcrs LiccnsrJStatc ID Nwnh-r (la,� 5 dicns) Othcr (plcscc speciF in Part? bclow) I
smre
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Fach undersignetl cenifies, under penalry of perjup�, that the above and foregoing infoRnation is we and correct and that he or slie is elieible to
recei��e the homeslead standard deduciion on this property. Each undersiened al;o understands that, by claiming addilional home[itead deductions
unlawfully, he o; she may be liable for back taxes and substanrial financial penalties.
O�.�ncr I Sicnat�m DaL- 7'cicphmc
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