HomeMy WebLinkAboutHomestead_Montgomery (3)4�5i•'F4' CLAIM FOR HOMESTEAD PROPERTY TAX
i �° CREDIT/STANDARD DEDUCTION
-�� ��� State Fortn 5473 (R2 / 5-92)
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fi . INSTRUCTIONS: See reverse side /orliling inshuctions.
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FORM
HC10
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YEAR
CERTIPICATION STATEMENT � � �j7
I(We � cgrtify�hat on the 1 st day of March, 19_
I(We) occupie as our principal place of residen e the followi' g escribed re pro rty tor w, c o� v rd�Prg�re T Cr is hereby claimed:
❑ I(We) owned ❑ Are buying under contract �`? GI�cSON Cf�UNT�UCITOR
❑ Have a beneficial interest in the entiry that is liable for the property taues on the property and thai owns the property or is buying under a contract.
� � CONTRACTRECORDED
If buying on conVact. Fee Simple owners name - �
Recorders office where contrnct is recorded Recortl number Page
PROPERTY DESCRI TI
Coun Towns�ip ' Ta�dng 'si' i Gry. wn � s�p)�
Parcel numyer� � � Legal descri � 1 / � � , \ � �^� � / O � �
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If arry portion of Ne resitleniial swc[ure or the tand noi exceetling one (1) acre ihat immediatety sunountls ihat sWCture is usetl to produce income, tlescribe Ne uu and ponion of
Ne pmperry uGlized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry � Township Counry Towns�ip
Si . re o G 'm �
�ereby certify the above statements are true, correct and complete.
Add umber and slreel, ciry, state, ZIP code) T
22 /�e� � P/(Ilvc+.�fd"J �N% y��%�
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately - �� �
surrounding residendal improvements.
Otherland (2)
Total land (line 1 plus line 2) (3)
Dwelling (4)
Resideniial improvements
Garage (5)
Other improvements (6)
Total impmvements (line 4 through line 6) (7)
Total value (line 3 plus line 7J (8)
I hereby certify the above is tNe. Correct, and Signature of Assesor Date signed
complete.
Verifying action - Signawre of Autlitor Date signetl
_� STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
lesser oi 7/2 Homestead y�
Valuation or 52,000
Si t e of Audit r Date sign /x'
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
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InJividuals anJ inarricJ coupk.� are limitcd �o nne home,�mJ �anAard AeJu.�iun. As �he receip[ M �hi_� daluaion Lrcmies
morc beneficial, thrrc is morc inernme Wn e�rr for M1omeste:rl fnuJ. IlomnteaJ faud causes hi_hrr taa bdls tur all: therc(ore.
H!A Gi3-?009 requim ucpa�en r.ho rccirc Ihe hanesa�aJ standard �tvluction �u vcrify ihai �hey ac cliciMe to rrccnr thr
brnefii aN to pnxide ad�iiiia�ui idrnufrfm_ infumu�uon ixxr.an� �o allw' cuunp' gm'rmment ro Y.;¢� monfror IwmesrcaJ
filirp�. This infmmation will M Aryw conii�icmial anA r.m nnly h� aam: mf br amMr'ved rountr niT¢iuls� The Dcpanmrnt of
I.ocal Gwrmmrnt Pivnm �cill u�e this intoemation w cream aol� �hat wiil h:lp eow�n officials dim�nVC homesteud haud.
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Tasnaver Neme Prnoern•Address
Montgomery, Michael L I
4109
Michael L Montgomery
3427 S 275 E
Princeton IN 47670.8735
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Olhcr (pl�e Speci(y in Part 4 bclow)
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digiLS) I Ochcr (Plcasc spccify in Part < 6ciow)
undersiEmed certifies, under penalry of perjury, that the abo��e and (oregoing information is true and correct and that he or sHe is elieible to
�e the homestead standard deduciion on this property. Each undersiened al>o unders�ands that, by claiming additional home i ead deductions
�fully, he or she may be liable for back taxes and substantial financial penal�ies.
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