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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 5473 (R2l 5-92) '
INSTRUCTIONS: See reverse side (or Iiling instructions.
FORM YEAR
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oCT i C� 1999
'�' ' CERTIFICATION STATEMENT ' ` ��% �/ '�/
I(VJe 1 certify�Nat�on the 1st day of Marc�h, 79l '
G:!-°SC' ' � uu�l.... .
I(VJe) c ie our principal place of residence the following d n real property for which a Homestead Property Tax Credit is hereby claimed:
❑ I(NJe ne ❑ Are buying under contract .
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
CONTRACTRECORDED �
It buying on contract, Fee Sunple owners name -
Recorders ottice where conVad is recorded Record number Page
PROPERTY DESC TION
Counry Township Tanin tli ' (ciry, own, lownship) - - �
Parcel number Legal dep�p lion
C4 -O �-c� C" � - �' O a- �l CJ.�
Ii any portion of Ne resitlential struc[ure or Ihe IariC noi exceetling one (1) acre that immetliatety s�rtountls ihat sWCiure is used lo produce income, tlescribe ihe use and portion ot
the pmperry utitizetl ro praduce income.
- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Caunry Township Counry 7ownship
I ignatu of imant
ereby certify the above statements are true, correct and complete.
L <-t
Address (num6e� and sneef, city. state, ZlP wde)
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately (��
surtounding residential improvements.
Otherland (2)
Total land (line 7 plus line 2) (3) .
Dwellin9 (4) .
Fesidential improvements
Garage (5) �
Other imprwements (6)
Total improvements (line 4 fhrough line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certity [he above is true, correCt, and Signanre ot nssesor Dare signed
complete. �
Verifying ac6on - Si9naWre of Audiror Date si9netl
�� STANDARD DEDUCTION ALLOWANCE
� 19_ Pay 79 _
Lesser of 1/2 Homestead r�
Valuation or S2,000
Signature ol Auditor Date signetl
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
1746
Sl1i£lOAU!!!Mllt_ /.W+1
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Y:AVCEMLI.1-l'J.1
InJiridual> anJ ma;riN coupla arc limited to onc home�caJ �anJaN J.�luaion. As ihc receipt ol Ihis dcdunfon 6ecomes
merc beneficial, therc ti morc incrnma than r�er (or homestead framl. Ilomnre�d flaud causes hi�hrr Wa bilk for all; the¢fae,
HEA I3S�3-?0f19 requim uxFren x�ho recei�e ihe hanestead sundard de�iuction iu .erify ihai r6ey am eligi'�e io mcene ihe
benefi� ani to pru��ide ahfi�imul iJrntiiyin_ in(wnv�tiun neressan� io allw' county gaemmenl ro betnr muniror homesx:q
tilirne . This inlormation will he AqM confidenlial anA a�n nnly M aratt�eJ by awM�iin1 rnuN�' nRcials. The Ikry�annmm nf
Loc�l Gommmem Fieunce will u.e �his iniormatiun m areate muls tlut e�ill heln munm uf&iak diminme Mmc.tead (. ud.
Joy M Maikranz
824 E Old Petersburg Rd
PrincetonlN 47670-8520
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lailine Addreis (Number and stree4 city, swte, �nJ "LIP cak)
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xial Securiry Number (�azt 5 digits) Driver's' Licen /�
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infoRnation is we and correct and that he or she is elieible to
e the homeslead siandard deduction on lhis property. Each undersigned al;o understands that, by claiming additional homest>ad deductions
fully, he or she may be liable for back taYes and substantial financial penalties. I
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