HomeMy WebLinkAboutHomestead_Nolei4�E STI�E�i
<
: ��
�
lfi
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 5473 (R2 / 592)
INSTRUCTIONS: See reverse side lor 7iling instructions.
FORM
HC10
YEAR
� 1"' a .
CERTIFICATION TATE NT
1(We) certify that on the 1 st day of March, 19_
I(We) occupie as our principal place of reside c ihe following described real property for which a Homestead Property Tau C��i� li�r�y�d:
❑ I(VJe) ow d ❑ Are buying under contract %f
❑ Have a beneficial interest in the entiry that is liable tor the property taxes on the property and that owns the property s buying,pnder a�antract.
�� ���
�ia -.• ��
� CONTRACTRECORDED
If buying on conVaa, Fee Simple owners name -
Recortlers ottice where comrect is recorded Record number Page
PROPERTY DESCRIPTION
Counry Township Taaing dis�riC� (City, town, township)
Parcel nOumber_ O ��c Legal tlescnption - �
w
If any portion of Ne resitlential structure or the land no� eaceeding one (1) acre that immetliatey sunountls Nai structure is usetl to produce income, describe ihe uu and portion of
Ne pmpeM �ized m praduce income. .
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES �
Counry Township Counry Township
Si re oi aimant �
_reby certify the above statements are true, correct and complete.
Add beiandstreet,ciry,state,ZlPCOde) '
- ,C3o y9
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately (� �
surrounding residential improvements.
Otherland (2)
Tota� land (line 7 plus line 2) (3)
Dwelling (4)
Residential improvements
Garage (5)
Other improvements (6)
Total improvements (line 4 lhrough line 6) (7) -
Total value (line 3 plus line 7) (8)
I hereby certity the above is true, correct, and Signawre of Assesor Date signed
complete.
Verifying action - Signawre of Auditor Date signetl
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead c�
Valuation or 52.000
Signature oi Auditor . Date signetl
. a ta-�
_ • I
+ � .aa*[�nAU.iw��iw.i nriuuvn:awa�n
V�Rtw'EUBxtl�tEBMRp(KMCYY.4�c.`nr �AfYNBFDOTIIPUF�M1W:Yf4FLMALC.U=_RVMfI�liTA\CF.M�I.I-L'11
Gibson County Auditor �
101NMain �� � � � � ' � ��� � � �
PRINCETON IN 47670 InJi.iJuals anJ rtu:riN mupka are limited io ore home3eaJ vandiN Jedunioa .4s ihe recerp� oi this ileduttion Mconres
�
marc 6eneficial, ther< i� nrorc inrentime than ner (er humesmsl Gaud. Ilumcsrcyl GeuJ caust hi�her tac bilL tur all: Iherefwe.
H!A 133i-]I%19 r�yuves ua�u�en who rcceire �hc hanes�cad sLindarJ JrAuction to .erilv iha� �hey art cltciMe lo mtti�e �he
benefit an1 ro p�w'ide atMlitiunal iJentifpinc infurmanun nem'vn� ro alloa' oounrc gv:rmmenl ro b;ver ;mUnitcX hume5rc:d
filirph. lUis inl'armaiion x'ill M Ae�L ennfidential anA nn nnly h. accr: sed Ay w�ho�iicA row�ir nfTiciulx.;l'he Ikpanmm�i nf
I xal Gm<mmem FinaMe will mt �his intorma:fon w crm:e Rvls that e'fll h:Ip co�mn� officiaL.- dimifurc hxnestead tmud.
• � � � • � —
T•rxpaver Name
Nole, James T/ Juditn A
,8,o c ��N��,�- Es��k-�5
James T/ Judith A Nole ��(� �j �^�'
R1 Box 49 State Parcel Number
Princeton IN 47670.9318
26-11-14-102-000.705-027 COLUMBIAEST 3 I
���ii��ni�i��i��iu���in�i�i�n��iin����i�ii��nii��i����i�
V I
��
�-
'-- �g.Aadmss�numocrand�>vm."cirv.smcc.anJZiPcuclrj—' - - —
`
� .Co�.urn� c I_
$ocial Sccurily Numbn (last 5 dipiLS) Ihiver's Littnsd5ut< ID INmnbcr Qazt 5 di:iB)
►-
Spouu ` First �
V u�
Mailin� Addres (�umbcr and sveel a}', sWtr, and "LIP cak)
cial
�s
Other (pie�se
Qazt 5 di6+its) � Othc[ (Plcuc
Same a� p�per.� addrs; - . _ - I . _ � _ .
S I
if iu Pan 4 below) l
N �'� C ��
�S+ :� P�DmY addres> �
I
if� in Pan 4 bclowl !
undersigned certifies, under penelty of pepury•. that the abovz and foregoing infortnation is truz and co`rect and that he or slie is elieible to
: e the homestead siandard deduction on this property. Each undersiened al;o understands tha�, by claiming additional homeitead deductions
sfully, he or she may 6e liable for back taxes and substanhal 5nancial penalties. �
� I ibmsnvc � Ihtc 7'dcphonc
. �
�p���S�;�rzascc� V�Y'zS � i,1c,l ���> �� l-lc l�
a
�, a
I L � ° eo�
A .�J �� y� u'