Homestead_Page (4)�+""2
4�, : t CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
�.• J State Fwm 5473 (RS / 70-01 J
PreSCribed by Ihe Department of Local Govemmeni Finance
WSTRUCTIONS: See reverse side loi liling insWCtions.
a�..�;;`�.� 'c �, - ` � � � :'CERT CATION STATEMENT",� �
I(We) •
I(VJe) occupied as principal place of residence lhe following described e pmperty for which a H
❑ I(We) owned ❑ Are buying under wntracl
-�Have a benefidal interest in the enfity that is liable for the property taxes on the property and that
If buying on contraa, Fee Simple owners name
Recordefs office where conuad is recorAed
FORM 1 ' .,,YEA --I
HC10 �,� �
�b� �
�. — ..
_ certif�l AS�f on the ts day of March, 20_
n{ead Propert T �edn is re Gaimed:
����""" "c��' �i jv FUDITOR
s(%B�6�rry or is buying under a contract.
..`v:::��-. _ .. « .>. ..r_. � -.
Retord number � Page
....,..r s.. .c � -,-r��.�, e 3's'':_ . '" .. -r-, sc . �-1.ti: �
; �r`x�� _ . .�_:. �;. . � ->- �a Y . n;�.__,.t--,. �..:^.�'<,..,_..:PROBERT.Y.DESCRIPTION r'� ,: _ .�,.^. �, � .:._. - -: �''.. � . �
Caunty Tavnship Tacing dislrid (ciry, fown. fownship) . '�
P cel nu ber Le I desc'O��on Is Ne property in question.
� - - O ❑ Real PmPerty ❑ 6lobile Homo p.G Sf.7-7)
If any porlion o( th resitlential sWCWre or the Wnd not exceeding one (1) acre thal imT ed' ely surrounds Nat sWCNre is used to produrs income, describe the use and ponion
of the properry utilizeE to produce income. ')•�554A
GY `
County To.vnship
I hereby certify the above statements are true, correct and wmplete.
AAei �c�lc n.nohr� cfrcaf � sfa�a ]IPrnn � .
MANT IN
Counry
of
Tavnship
,..,t �
3i'y��i�'F, �'%,�.,�"`Y�°�"'.ry ty �:��a tiit �- '_� . .
��=4 �� ASSESSOR USE ONLY , -�s TRUE TAX L> ASSESSED VACUE �>HOMESTEAD� ��s}NON RESIDENTIAL`��^ ����
�r;:.s:l:' .�..�-'�"}..-.:-»_�' t.C'-g'.-?'t:'.�. . "�,'�� �.t �.r � VALUE:.' . 3. � AT.100%OF-TTV -VALUEE'=,q �¢ ` �" �VALUE - �� .a'�:�s
.. �,�i., .�2-s �,r : t-xld.
Land not exceeding 1(one) acre immediatety _ E �� �"�`y� i a^'":,.'.�.z v�
sunoundin residential im rovements. (�� ` �fi ��'� �' ` °P.7
9 P ..�r41 J. _� i Y tJ�'� 1`
Ofher land `{{ ��`� - -
(2) t 7n_+�- �^�' :
� . �...�,--'__"-'�
Tdal land (line 1 plus line 2) (g�
n
Dwelling (4) �3� �=-��sr y� Y �` � � �➢ n.y
Residen6al improvements , -
Garage �5) ��1-'t.������_,�«�,-q"r�s"'>:::
�s�,
, ?'; �a
Other improvements (6) _ � _„�'s.� .
Lz� �u
To[al impmvements (line 4 through line 6) (7�
Tdal vatue (line 3 phs line n (g)
I hereby certify ihe above i5 We, corteU, and Signature of assessor Date signed
complete.
Ve`ilying acl'an - Signature oflwditor Date signed
���'.�''�`,c-�j��-;�= �.. %:�'-�+.:sx`�Tx T '<i��ti�-�' a� _�::STANDARD.DEUUCTION-'ALLOWANCE F G'.?.'-�i:s i _��.:+'t.--� -: ��#v �Ysi��:-.
20 _ Pay 20 _
Lesser of 1/2 Homestead
ValuaGon or 56,000 S
SgnaWre of Auditor Dale signed
•
Gibson County Auditor
101 N Main
PRINCETON IN 47670
1644
Cory A/ Cheri D Page
2557 W 275 E
Princeton IN 47670
t1AtE fDlLfl ��fNIR=/ YPI
1RCnti11�FM fOAV Yln
IndividuaLc anJ marriN coupks a�e limi�ed to ore hameycad aa�MaN dcviunion. :�s �he recerpt oi this dctlunion beconms
mure beneficial, there is morc incentne than rcer (or M1omnrcxl fraud Ilomea�ead fmud causs higher tac bills for all: therefort.
HEA 1341-]009 rcquim uxpapers who receive ih hanestead standvd dnluction m.erify �hat the} am eligiMe to mcei.e thc
benefit anl to p�a'ide adclitio�ul identiiyin� in(ornutwn �rt�cnsan� ro ailw� counp� go.emmcnt to Nuer mmitor homrneacl
filin��.'ihic iniorma�ion will M Ae7v canfdeniial and on only R: acec>ud hy autMrirnl counry nRcials. The Ikrynnrem of
I.ceal Guvcmmcnt Pi�uM< ��ill u�c �his infortnation ro crcatc uvls ihm will h:Ip ootmq ofAcial. dimiwl< homc9caJ (raud.
Tamaver Neme
Page, Cory A/ Cheri D
Propertc Address
�f� �v a�sF
R2 E3ox `�
Princeron M 47670
C��
State Parcel Number Leeal Descriptian
26-12-27-100-000.081-027 006-00081-00 E NW NW 27 210 2z55a
aC o-io
_ _�
This form MUST be retumed to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.