Homestead_Jines (5)Gibson County Auditor
101 N Main
PRINCETON IN 47670
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0
InJiriJuals m�d ina:riN coupks arc limittd �o one homeaead 9andaN JeJunion. As ihe �mtip� of ihis Jeduction beconxe
more brne5cial, there is morc incrntnn dun nrr (er home�tead fnud. Ilom�ead frauJ cauus hi�her ta� bills (ur all: thertfore.
HEA 13di-�IM19 rtquira m�payen w�ho receive the Mxnes�eaJ uandard Jttluc�ion io .e�ily iha� �hey am elieiNe to recei�c the
brnefit an1 ro piP'iJe aJditiunal identin'in_ inGmtt�hon Mce.'vey tu alltrv,' counn' go.�tmmrnt ro W.nrr mtnitw homesttad
lilin�.'Ihic inlormuion xill M Aryv contidenlial anA �n onle M: aarttacJ M1�' amhorizcd cnunry' ofl'mial>IThr Ikpanmcm nf
3383
RobeR J Jines Jr.
1400 E Indian Creek Est
PRINCETON IN 47670-8971
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Address
S�BIC,
Addrtss (Number and �aL ciiy, stak, anJ ZIP wik)
Taxpaver Name Prnoert�� Address
Jines, Robert J JdJoy L !
R2 I3ot 26?
C%---� Princc�on I\ �7670
1
State Parcel Number Lesal Description
26-12-09-103-004.186-027 006-04186�00 INDIAN.CREEK PH I i-PH III
8/9I70 C-1
X
,
i
S
eJ ineS �r i
— - — .1 I,tl§me as pmpem on'a�-, — -'—
�ba i
zN '�l �� 0 '
Nmnber (lut 5 digiU) I Other (plcsse specif in Pan 4 below�) ;
I
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�n�
�u pmpeny addres�
Sccurity Number (lan 5 dieia) Drivcr's Liccnsc/Slatc ID Numbcr Qant 5 dieits) Othcr (plcasc specify in Pan 4 bclow�) '
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undersi:ned certifies, under penalty of pequry�, that the above and foregoing infonnation is true and co�rect and that he or she is elieible to
�e the homeslead standard�deduclion on this property. Each undersi¢ned also understands that, by claimine additional homescead deductions
�
�fully, he or she may be liable for back taxes and substantial financial penalties. !
I$i�manue � Uste Tcicphonc
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CLAIM FOR HOMESTEAD PROPERTY TAX
" CREDIT/STANDARD DEDUCTION
t � State Form 5473 (RS / 10-01)
� Presai0ed by ihe DepaAment of Local Gwemment Finance
See reverse side Ior 61ina instructions.
FORM ^YEAR
HC10
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.�. .�.t.J .L._.
I(VJe) certify tliat on tha 1 st day of.March, 20 n
I(We) occupied as our prindpa lace of resid the Ilowing scribed real property tor which a Homestea��roperty T�i Ciedit isytiereby.daimed:
❑ I(We) owned ❑ buying unde ntrac GI�56ta etlUrft fi� �uo�Tqq �
' Have a benefidal interest in ihe entity thal is liable for the property taxes on the property and that owns lhe property or is buying under a contraU.
I( biry'vg on tontraq. Fee Simpie owners name
conVact
Coun / Tamship
Parcel nu r L e:
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If any poNOn of Ne residentlal sWCWre w tha land not
ot the praperry utilized te produce incoma.
Record number � Page
� � �� � =7 —� � � Real property ❑ blebfle Homo (I.C. &7. f-� .
aie (1) aae tliat immeEiatey wr`ounds ihat st'rucWre is used b produce income. tlescrihe the use and pwtion
Y' Y i.� �r±` ..'�^v'.� ; ��.v,T'��:STANDARU:DEDUCTIONALCOWANCE�i_a"s'3"��i�'.%�`'kt�.�'.�R�'a.'�'`.�- '.�-"�9.t�Y"`^`'�"r`� :i%'.3�
:���``�' �n,��xisSi dii�lel��- - �.
20 _ Pay 20 _
Lesserof 12 Homestead $ --
Valuatlon or 86,000
Sgnature oflwditw ' Date s"qned