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Homestead_Riedford��_��., CLAIM FOR HOMESTEAD PROPERTYTAX FORM d�r• ;;'""°;' � CREDIT/STANDARD DEDUCTION ��� HC10 � ;�. State.Form 5473 (R2/1-90) �� INSTRUCTIONS� S d for filin �nstr ctions . ee reverse s� e g, u 1/ CERTIFICATION STATEMENT � � I(We) I I I� l�nS� y( .��a.Y �•\��ClCa1,� certify that on the 1st day of March , 19 � � �Ve) occupied as our principal place of residence ihe following described real property for which a Homestead Property Tax Credit is hereby claimed: t..�t"�) owned ❑ Are buying under contract � Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying it under a contract. CONTRACT RECORDED If buying on contract, Fee Simple Owner's Name Recorder's oifice where contract is recorded Record Number Page PROPERTY DESCRIPTION Taxin�Qjsyicy (City, town, township) Parce�l N� m OI ��� I Legal Descripiion �� � �� O �� 9- , �w y �o-a-►� 80.so�+c �a If any portion of the residential siructure or the land not exceeding one (1) acre that immediately surrounds that struc- ture is used to produce income describe the use and portion of the property utilized to produce income. OrT 3 l �99� PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES County �_ Township , County certify the above statements are irue, correct and ( Signature �Gj Jl � r%) � jVQ.(/ `Cn�.t�J` �(Siree number, city state and ZIP code) ( a, ��k�lo� lad (�dx2S9 `h���c_�a-,,� ,.,�� �F7(a�n ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL ' VALUE Land not exceeding i(one) acre immediately � surrounding residential improvements (�) Otherland (2) Total land - line (1) plus line (2) (3) Residential improvemenis Dwelling (4) ' Garage (5) Oiher improvemenis (6) Total improvements - line (4) lhrough line (6) (7) Total value - line (3) plus line (7) (8) I hereby certify the above is true, Signature of Assesor Date Signed correct, and complete Verifying Action - Signature of Auditor Date Signed STANDARD DEDUCTION ALLOWANCE 1989 Pay 1990 � Lesser of 1/2 Homestead Valuation or $2,500 Signature oi Auditor n 1990 Pay 1991 Lesser of t/2 Homestead i i � Valuation or $2,000 � 1991 Pay 1992 19—Pay 79— Lesser of 1/2 Homestead Lesser of 1/2 Homestead Valuation or $1,500 Valuation or $1,500 Date Signed �.. . �i _U�^ Gibson County Auditor 101 N Main PRINCETON IN 47670 – —_'917 � Michael R/ Gail A f 2950 E Top Hat Rd Princeton IN 47670 I�I��II���l�ll��l���llis InJiciduaL. and rtu:riN coupkti are limi�cd �o oce homc�eaJ �andartl JcAunion. As ihe rccctip� ot �his�dcdunion beconre� morc beneficial. iherc i> morc incenmr Ihan e�rr for M1omes�ead Gaud. Home'mad fraud causes hicher taz bflls for all; Iherefae. HEA 1 i4q-2009 rcquves uspacers who receire �A< Iamestead sundard dttiuction m.eri(y ttut e6ey are elicide m meci.e the benefii ani tu p�w'ide addfifonal identiirin_ inWrmanun Mce.-vrv to allw' cwnrv gm'emmrnt to beeter muniror homareaU filiny�. Ifiis info�maiion xill M Aryw crnfideminl anJ can onlp h: accesseJ 6p amharived counry� o(ficiulsJThe Ikpanmem ol Local Gm'emmem Fivcee ��ill mc [his intormation ro ercatt twis that will h;ip epmn• ofSciaL. dimi�Ve M�me.Jexl fraud. � � � � • � — Tasnaver Neme Prnpertc Addre�s Ried(ord, Michael R/ Gail A I az �30. ?ss I Princeton IN d7670 i�ii�i�ii�n�i�i���ui���i��ni�n��� _� ------ —� .. — -- State Parcel Number Leeal Des 2612-10-300-001.661-027�oos-o1661-0o PT V �-� 1 First nfiddl M,�►��� �Qy � Addmss (numbcr and strm. <iry, sutc. andZlV2odc) — - — - " � -- � — � � ed.�o r� m pi�µn:. uidnas- tso E To Na+ r2d Pr�ncpfon� s�v 4��,�0 G4; i �Nu � I e�For� e Address (Number and svee4 �q'. sWle, and "LIP cak) �$ame ati propem adJrcti aA50 E T�P Fiui� R.d Pr� nce ta n� ,�-N 4�m70 Stturiry Numbcr (last 5 diei�s) Drivers Licensc/Sta[e ID Nwnbcr (laie 5 digits) Other (plcase speci(y in Pan 4 below) 10210 80AC undersismed certifies, under penalty of pequq�, that the abo��e and foregoing infurmation is true and wrtect and that he or sfie is eligible to :e the homestead standard deduction on this property. Fach undersegned also unders�ands that, by claimin� additional homee.ead deductions �-fully, he or she may be liable for back taYes :md substantial financial penalties. I ISil.mame � n �1 /� /1 Detc Tcicvhonc � - / � y/a�iv oai� N/ 9��0 � �