Homestead_Mizeur�„ ...n
���� CLAIM FOR HOMESTEAD PROPERTY TAX
a� CREDIT/STANDARD DEDUCTION
State Form 5473 (R2 / 5-92)
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INSTRUCTIONS: See reverse side !oi liling instructions.
. . .. . - � . . - .. . - --`�CERTIFlQATION STATEMENT;',•.., ...
FORM YEAR
HC10
I.NJe) � certify that onc t�he 7 st daX� pµ,�arch, 19_
�le) occupied as our principal place of residence the f I�Hnng esaibed r properry for which a Homestead Pro{�ryy�aiCr'edifiSffEreby daimed:
�J I(We) owned ❑ Are buying under coniract � 0 (/,{I� �
❑ Have a beneficial interest in the entity that is liable tor the property taxes on the property and that owns ih�opert�9ryisbuyurg unAef,3("corit�act.
� � � .- . CONTRACTRECORDED�-�"- - - - ��_ } _- - - �
If buyinq on contraa, Fee Simpie owner's name
Recorder's oHice where comrac� is recortletl Record number Page
. . - .. - .PROPERTV DESCRIPTIOM - � . � . - . s .. � . . �
Counry TownsNp Tazirg district (ary, town, rownship)
Pa�cel number �egal descnption
00 - o�g-� v� _
If any portion of t�e resitlential struaure or Ihe land not exceeding one (1) acre that immediately surtounds at struaure is used ro produce income, descnbe the use and portion
of ihe properry utilizetl to protluce income.
� ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
� VALUE VALUE VALUE . �VALUE �
Land not exceeding 1(one) acre immediately . ' �
surrounding resideniial improvements. (�) �
Oiher land (2) � � "
ov',
Total land (line 1 plus line 2� (3)
� Dwelling (4) � ' �� . .'
Resideniial improvements .
Garage (g) � . - '
Other improvements (6) �
Total improvements (line 4 through line � (7)
Total value (line 3 p6s line � (g)
I hereby ceRify the above is true, correci, and Signamre of Assessor Oa;e signetl
complete.
fyirg aaion � SgnaNre of Auditor Date signetl
�
- ' 'J
Gibson County Auditor
101 N Main
PRINCETON IN 47670
�
sT�v[ wax ��w�tii rw�
1RFASUALA PoRV 31A
Indiriduals anJ ma;ritd couple are limi�ed �o ore honrcycaJ sundaN dniunion. .4s 1he rmtip� ol ihis dcdunion 6ecomen
morc beneficial, there is morr fncenm�e than ecrr for homesrcaJ fqud. Homottazl fnuJ causes hi�hrr iac bills for all: thertfae.
HEA 13-N-?IXM requ'un uzpa.ers x�ho receire ihe hanesteaJ swndarJ dnfuction to .erify that tAe} am eligiMe w recene the
benefi� aN io pm��idr addnio�ul iJmtiipinc infomu�mn Mcrs'vn� to allw� counn� gmrmment m beti•r moniror homrnesl .
filim�.. Thic information xill 6e AryM mnlidrnital anA r.m only R avre..ed 6.' awlror"vni roumy MTioius lTe Ikparmxm of
�
Local Govertvnent Pi�u�rce ��ill u.e this iniomu:ion m creah � vis tlut will heln mtmtt' otiitials dim�,vm homesrcad inud.
T•rxpa��er Neme
Mizeur, Chadwick P
� . I77i Conainl DR
O� ���C$s /r Princcton I�'�i7670r ��
499 I U
�((a�/�css � Loc/tTZUn'�
Chadwick P Mizeur �/!7y I SAM
541 S Concord Dr G l
PRINCETON IN 47670-9325 State Parcel 1umher Leeal Descrintion
I�I��II���I�II��I���III���I�I����II���I�I�I�I��I��I���II��I�II 26-ii-i4-101-000.07s-027 COLUMBIAV�L�nGESECt 7 D-1
_— -- - ---- -- ----- �- --�_ _ _ �--- --
This form MUST be retumed to County Auditor's office.
Please do NOT send this form back with your tax payment to the county
.�ner I First M
C+f�F��JSC l< i��4- u L
ng Addrtss (number and imxt, ciry, smtc, end ZIP code)
S`�I S, Cpn�eo2� c72, r�2s,u�Erorv,-r,v
cial
VUlzz �-z,�2-
'$ume ns pmpem oddrts;
7c7o
iF in Pan 4 bclow9
�o13��V I � L4'n� �%IS-zEktZ
iline Addre� (�iunber and stree4 ciiy, staie, and LIP caie) 1-1Same as pmpeny addres;
N1
.S�I I S, CQ�1L0217 17iZ • �NLc : c-`!U �_ �� �-'�%(o� t7
ial
undersiened certifies, under penalty o( perjury•, that the above and foregoing infocmation is we and co�reci and that he or
,e the homestead siandard deduc�ion on this property. Each undersigned al>o underslands thal, by claiming additional hom
,�fully, he or she may be liable for back taxes and substantial financial penalties.
�I Si Uam Tclephone
��� �ll�l� (
��
urer.
:licible to
deductions