HomeMy WebLinkAboutHomestead_Ivyt,< R.,,
db i CLAIM FOR HOMESTEAD PROPERTY TAX
z��: CREDIT/STANDARD DEDUCTION
�,,,� State Fortn 5473 (R2 / 5-92) (A
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INSTRUCTIONS: See reverse side /or /iling
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YEAR
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�I� e(iJ1_/" . � . � certity ihai on ihe ist day of March. 79�/
) occupied as our principal Place of residence � owing described real property for which a Homestead Property Tax Credit is hereby claimed:
� I (We) owned ❑ Are buying under comraci . . . � _ . . .
❑ Have a beneficial interest in the eniity thai is liable for the property taxes on the property and that owns the property or is buying under.a contract.
� � � . -- CONTRACTRECORDED, - � � � - - �
If buying on tontraci. Fee Simple owner's name ' ' • � ' •
Recorder's office where contract is recorded Record number Page
Counry
i/JS
Parcel number
It any portion of the resi,
of the properry utilizetl �o
PROPERTY DESCFiIPTION
fownship)
ar the land not exceetlinq one (1) acre that immetlia.ety surrounds that structure is used to protluce income, describe the use and portion
e. �
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES � '
Caunry Township County Township
�eby certify the above siatements are true, correct and complete. Signa e ot claimam
Atldress (numberandsbeef, aty, sfafe, ZlPmde)
ASSESSOR USE ONLY � TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE � VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvemenis. (�) '
Otherland �2) '
Total land (line 1 plus line Z� (3�
Dwelling (4)
Residential improvements -
Garage (5�
Other improvements (6)
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line � (g�
I hereby Certify the above is lrue, corrett, and Signamre ot Asseswr Date signed
complete.
�ing aclion - Signature ot Autlilor Date 5igned
L
Gibson County Auditor
101 N Main
PRINCETON IN 47670
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3376
Christopher D Ivy
1546 Outer Lake Rd
Pnnceton IN 47670
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IndividuaL� and marrinl coupkz arc limi¢d �o orc home�aeaJ �andaN ANu.tion. As thr rmtipt ol this Jaduninn becomes
more beneficiaL �here is morc fncrntnx than raer (or M1omnrcaJ fiaul. IlomeNead iaucl caasa hi�her ta: bilis tar all: therefae.
HEA 13�-1-3IX19 reqvim mxp��ers who receire t6c hannicad swndard JeJurtion to rerify Out �hey ore CliciMe io recene ih.
bcnefi� amf �u prtw�idr :xNlitional iJemiirine infortnatiun Mcr.vn� ro allw� counn� gm'emmrnt to b_ve munitur homesrcaJ
filinE,�.'lliis inlam�.itinn will M Aryu mnlidential anA ran nnly M arm�ed hy nwhorireA rounir n�iicinl7'I'hr Uepanmem nf
I_ucal Gw<rnment Pinance ��ill u.e �his iniurmation W aream tivl= �hm will hclp cwnn� ufficial> climmne homes�cad (nud.
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Tazp•a��er Name Prupertc Address
Iry, Christopher D
s% � / 1 S�6 Omcr I�kc Rd
� � Princeton INi 7670
State Parcel Number Leeal Des�
26-12-09-103-Oq1.424-027 oos-o1424-00 PT
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9 2 10 .834 AC
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Oaner I First Middk I LaSt
�' h�er ( c�Je . _1-.v
C Address (number end sveet, city, stale, and ZIP code) �Snme as propcm addres; �
Social
MidJlc I Last
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Mailinc Address (Nu r and stree4 �i)'. stale, und "LIP nwk) ��e u pmpem address I
_ Social Sccurip'.Numbtt (lazt 5 digirs) `. Drivcrs' Licca�Statc ID,Numbcr_�la.� S digits) Ochcr (plcaic spcciN in Pan _bclow�)__,_ __� _ __ ,
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Each undersiened cerrifies, under penalty of pequry•, that the abovr and furegoing information is we and wrrect and that he or she is elieible ro
receive the homestead standard deduction on this property. Each undersi¢ned al;o understands tha� by claimine additional homesl ead deductions
unlawfully, he or she may be liable (or 6ac4 taxcs and subsiantial financial penalties.
Ownc� 1 Signawrc Dnlc '1'cicphmc
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