Homestead_Jaquemai..�^•�. CLAIM FOR HOMESTEAD PROPERTY TAX
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3�`: y - CREDIT/STANDARD DEDUCTION
�:,� State Form 5473 (R2/1-90)
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT
_ - FORM _ YEAR
HC10
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M(We . . y at on the 1st day of March , 19 �
I(We) cupied as our principal ce of residence t e f o g described real property for which a Homestead
Property Tax Credit is hereby claimed: , I(�We) owned ❑ Are buying under contract
� Have a beneficial interest in ihe entity that is liable for the property taxes on th��e�a�r�t q►vns the
property or is buying it under'a contract ��
CONTRACT RECORDED
� on contracL Fee Simple Owner's Name
�r's office where contrad is recorded
.-. PROPERTY
Parcel Number Legal
Ao G -o�99'R-rr,,
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if any portion of ihe residential siructure.or the land not ezceeding 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 COUNTIES
�reby certify the aboJe siatemenis are true. correct and S ture � �j _
iplete.` � � Q�.ti=-P: 5/-4 (�LcP.
jfe�ss (Str �t, n�mber. Gty, stat�ZlP, code� ���
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� - ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE
NON-RESIDENTIAL
VALUE
Land not exceeding 1�(one) acre immediately �
surrounding residential improvemenis (�)
Other land (2)
Total land - line (7) plus line (2) (3)
Residential improvements . Dwelling- - (4) - ' � - - - ' - -' �' '-� - '
Garage (5)
Other improvements (6)
Total improvemenis - line (4) ihrough 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 1990
Lesser of 1/2 Homestead
Valuation or $2,500
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STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991 1991 Pay 1992 19 — Pay 7 9_
Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead
Valuation or 52.000 Valuation or 57,500 Valuation or 57,500
/1/1�/1,.0 � • ! / I ,�.1.QiL,L�-_ �te
Gibson Caunty Auditor
101 N Main
PRINCETON IN 47670
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IndiviJuals anJ marriN coupin arc limiicd to orc homc,tead aandaN d:rlunion. As the raripi of thi�l dcJunion brconm
mere beneficial. �hrre i� morc incencne dun n<r for honmmacl (nuJ. Ilomesreacl fmml caass higher tac tills (or all: there(ac.
HEA 13J1-'_fll9 requves mspa.en who rccci.e the hanestcad siandard JNuctian m.cri(y tlu� they are eliciWc io reaene thc
benent aN ta p`u�idc :xlJiiional iJrntifrinn in(umcrtWn neaz-vn� to allw' cwnn� gu�emmmt ro betr.� mmiiw Iwmrnea!
�ilin�n.'lliis inlmmninn w�ill be I.ryM mnlidenlial anA ran nnly h` arce�uJ 6y aWhorized rouny� o1Lci;dsl. �ITr Ikpanmem nf
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Local Gmommem Fifu�rce ��ill uac this iniortnation W aream wuls iMt will hdp cvunn� offwial. clim�mm humcsicad fiauJ.
� Taipever Namr Propertc Address
Jaquemai, John C/ Suzanne M
— H2 �30� 77 \V
Princcionl\IJ7670 �
3626 I
John C/ Suzanne M Jaquemai
659 S 150 E State Parcel Number Leeal Descriotion
Princeton IN 47670.8825
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Driveri Litt2m/Sute ID Number (lul 5 digib) I O�hcr (pinse specify in Part 4
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Mxilim_ Address (Number mJ sutt4 ciq�, state, and ZIP caie)
Social5tturirv Numbcr (lu[ 5 digi[s) Drivcrs Liccnsc/Stare ID Numbcr Qa t 5 digils) Oiher (p
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undersicned certifies, under penalty of perjury�, that the above and foregoing infurtnation is we and cortect and that he or slie is elieible to
ee the homestead standard deduciion on this property. Each undersicned also undersmnds thxt, by claiming additional homestead deductions
✓fully, he or she may be liable (or back taces and substantial financial penalties. n I
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