Homestead_Memmer (4)d�; 4 CLAIM FOR HOMESTEAD PROPERTY _TAX
:� � ' CREDIT/STANDARD DEDUCTION
����' State Form 5473 (R2/1-90) `
'°'• INSTRUCTIONS: See reverse side lor filing instructions.
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CERTIFICATION STATEMENT
FORM _ _ YEAR
HC10 D
that on the 1st day of March , 19 �
�(We) occupied as our princip�( place of residence the fgl4ewing described real property for which a Homestead
/
Property Tax Credit is hereby claimed: u I(We) owned ❑ Are buying under contract
Have a beneficial interest in the entity that is liable for the property taxes ori the property and that owns the
�' property or is buying it under a contract. -
CONTRACT RECORDED
County
AUG 0 �
- PROPERTY DESCRIPTION • . •
Legal Description
town, township)
Jl�llO-(J I.�CJ S I r''� �1AIl�' ��-{� J 3-o['-JU d•V�7 H,[
If any portion of the resideniial siructure or the land not exceeding one (1) acre ihat immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
' � I I 70 — a so 0
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township . County _ Township
I hereby certify the above statemenis are true. correct and Sign ture —. '
complete.
Address (Street, number, city, state and ZIP code)
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land�not exceeding 1(one) acre immediately � - �
surrounding resideniial improvements i�)
Oiherland (2)
Total land - line (7) plus line (2) (3)
- Residential improvements Dwelling � (4) - - •- -
Garage (5)
Other 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
7 989 Pay 1990
Lesser of 7/2 Homestead
Valuation or $2,500
of Auditor
STANDARD DEDUCTION ALLOWANCE
1990 Pay 1991
Lesser of 1/2 Homestead
Valuation or $2,000
1991 Pay 7992 79—Pay 19—
Lesser of 1/2 Homesiead Lesser of 1/2 Homes[ead
Valuation or $1,500 Valuation or $1,500
` .��i
Gibson County Audiror
101 N. �Mafn Street
Princeton, IN 47670
'� FII,ED
— MAY 31 2012
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GIBSON COUNTY AUDITOR
4135
Thomas J/ Jodie G Memmer
990 N US Hwy 41
Princeton IN 47670
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Indieidual. and mvriid muple.. mr limi�nf w one honw�nnJ s�anS�rd Jeduciion..4� the rttrfW ��:ni� Jcvluctiun becomc�
morc bcncficul. Ilw�rc is mom ir.crn�im �tun cccr Inr hom:au�ad (mud. ilancstcad (nud c�o�cs ii_M1cr uc billr lor sll: ihcrc(om.
HF.A �3;4-2qp ¢yuir�s taxpacm who rmivt tht home.tad NanJarJ deduceion to mrif)'tF.at �hey an eligihle to �<tici�e �he
0.mctii aml m p�m�idc a�kii�ion9 idcmifi�mg ir,lixmauon m:cs�an� m albw mumy em'cmmcm :o Ccun� nxmi�ar homc� �d
filinu. �fhi. infumu�im vill be A��a confukntial and cin nnn� M aar;snl bv au[hanzeJ coun�q o0icid�� 7'he Ueparimer.� of
L�xal Gnocrmrn� I�inancc ..ill mc ihi. information m crnir mol? �hai aill M1rlp counR� n(ficL16 climinitc homc.�cad IiauJ.
� � � . �
TaxpaverName LocationAddress
Memmer, Thomas J/ Jodie G
2279 E 3�0 S
PRINCETON IN 47670
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State Parcel Number Leqal Descrintion ��`
____._26-]2-33-200=001.303-027 PTNE 33210 2.04:iAC D-10
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
`«-�o m
Addrtss (numbcr and svcct, cily, stau, anJ ZIP codc)
_ ' . r _ l'
�O�IE
(Numbcr znd s•mt. ci�p. statc. and ZfP code)
Sccurrty M1umbr. (las� i digits) Uri.ci s
.
Fach undeniened certifies, under penalty of perjury. that the abore and foregoing information is we and wrrect nnd thai he or she is eligible to
reccive thc homestead �tandard deduction on this property. Fach undersiened also understands lhat, by claimine addi�ional homestcad dcductions
unlaw(ully, he or she may be 1ia61e for back taxes and subs[antial financial penalties. '
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