Homestead_Pickensc �4
e�^ g CLAIM FOR HOMESTEAD PROPERTY TAX
s,�1���-r.,?''� CREDIT/STANDARD DEDUCTION
;�Fm..` � State Form 5473 (R2 / 5-92) �
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�eis
INSTRUCTIONS: See reve�se side tor liling ins(ructions.
- �FOR� � Y AR
HC1
�d��9 3 U 1994
e) _�_(�1../ / _ � _ ���. Y � �-C/1(/•.�� � .certify that on ihe lst day oTTvf�rcfi,'f9�
') occupied as our incipal place of residence U foliowing described realproperty for which a Homestead Property Tax Credit is hereby daimed:
I(We) owned ❑ Are buying under contraci . . ,' � .
Have a beneticial interesi in the eniiry that is liable for the propeny taxes on ihe property and that owns the pmperty or is buying under a contract.
- CONTRACTRECORDED •-
It buying on contrect, Fee Simple owner's name . ,.
Rewrde(s oHice where contract is recortletl Recortl number Page
PROPERTY DESCRIPTION
Taxing tlistrict (ciry, town, township)
r�,��,
Parc i number Legal description .
a� ce-o,��-ed �I-s� : NC 9-� - �o �f.,sa �
If any portion of the resitlenual struaure or Ne lantl not ezceeding one (7) aue that immediateiy surrounds that structure is used to produce income, Aescnbe IDe use and poNon
ot Ne property utilized ro protluce income.
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
. VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately
surrounding residential improvements. (�)
Otherland (2)
Total land (line 7 p/us line � � . (3) �
Dwelling (4)
Residential improvemenis
Garage (5)
Other improvemenis (6)
Total improvements (line 4 thiough line � (7)
Total value Qine 3 p6s line 7� (g)
I hereby certify the above is irue, correci, and Signamre ot Assessor I Date signed
complete.
.irg aaion - Signature of Audiror _ Date signed
19_Pay79_
Lesser of t/2 Homestead
Valuation or 52.000
Signature ot Audiror
STANDARD DEDUCTION
S
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.. ,
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
1
3393
Gary UMary R Pickens
2035 Outer Lake Rd
PrincetonlN 47670
ra. suuxwav��n
InJn�fduaL. and ina:riN <oupks arc limi�nl to onc hnmeucad �tandaN Jnlunion. As �he �eceip� a ihis Jeductan bttromes
merc bemficial, thrrc i� morc incenmx than ner (or homrs�eael frauA. Iiomes�ead frauJ ouus hi�hcr ta� bills (or all: themfore.
HEA 1333-2009 requim taxpa.m x�ho rcceire thc hanes�caJ standard �kilunian tu verity itut they am�dieide io recenr ih.
benent an1 ro pnr'ide acklitio�ul iJrntin'inc inf�xmatian m�r'vey to allw.� aounrc grn�emmrnt ro beu:r munitw homrs�ead
tilin� .'Ihis in(nrmaiinn will hr AryV rnn�ideniial anA pn nnh' Ft acre. uJ by autMri�N rnwp� nfTicia�.ti.'ITr Ikpannrnt of
Local Gm<mmcm Pi(u�e will u�c �his mimma;ion [u cream ro�ls tMt a'ill h:ln ��n� ulfiials elimiwtc homcst<ad M1aud.
Tazparer Name
Pickens, Gary L/ Mary R
?035 Owcr Lakc Rd
Princctnn 1��47670
Stare Parcel Number Le�al Descriiition
26-12-09-200-001.437-02�00&01437-00 PT SE �NE 9 2 70 4.50 AC
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Lezs (num6cr end svret, ciry, stare, and ZI P codc) � Snmc � propem addrev
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ily Numbcr (last 5 dieiLC) Dmds LittmdS�ate ID Nmnber Qact 5 digits) O�her (plcice specify in Part 4 below)
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Address (Number and svee4 c�i)', state, anJ "LII' wtk) � S:une e� proyeny add�a'.
Z C 3 5 � u-f -er 1.�� '�CQ .
ecurity Numbcr (lan 5 dieiu) Drivcls Littnsc/Siatc ID Niunbcr (ia,t 5 digits) Otficr (plcacc spcciH in Pan: bclow�)
__� -- -- - -- -
Each undersigned certifies, under penalty of perjury, that the abo��t and foregoing infortnation is true and coirect and that he or she is elieible to
receive the homeslead standard deduction on ihis property. Each undersi¢ned al;o understands that, by claimin¢ additional homestead deductions
unlawfully, he or she may be liable for back taxes and substantial financial penalties. '
OwMr 1 $ipukat_ . . �� Ihte . . 7'eltphone � _
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