Homestead_Riley� °�*v
:� t CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
= CREDIT/STANDARD DEDUCTION HCto
'� •.�� StateFwm5473(RS/70-01)
Prescribed by Ue DepaAment of Local Govemment Finance
INSTRUCTIONS: See reverse side (or �ling insfructions.
��e� n,iu t1�au�uw� the 1 st day of March, 20
,I�(,V/Je) occupied as our principal place of r� ence lhe following described real property for w/h�ich a Homesg d�o-pelr y T�c Credit is hereby daimed:
� I(We) owned ❑ Are buying under contrect / _ i �' ;,
l'
Have a benefidal interest in the entity ihat is liable tor �he property taxes on the pmperty and�that owns the property or is buying under a conVact.
If buying on conUad, Fee Simple owners name
Recorders atfice where contred is recorded
If any
of Ihe
Record number � Page
Tamship T'n di ' t �ty, t wn, to )
escription Is the property in Quwtion:
—� � — � O ❑ Reai Droperty ❑ Mabila Hwno (1.C. 67.7-7)
sWCture or the d not exceeding one (1 � aae ihat immediatey wrtounds thai sWCture is used b produce income, describe the use and portlon
ite intome. . Q S(/Q� '
r �
��—�%� '�: 3-�'"�"n ��� � ��. �rs- r � ., �„
�i..'��ASSESSOR�USEONLY�4�{�"?�y�'Y,VALU�Ix�y� ATaE00%'OFTTV 2 HOVAL E�D"� v�NON VALUENTIAL -�,�
�� R1X�a�.�;� �$�it3�.�'c� rr�... ;� a. ,.5.. ,[s �s:r K ".�., � �., si�-i,>?e� ..`f��.,.v�___
Land not exceeding 1(one) aae immediatety ' ����,.� '° ��,.y lw�>� k �
surrounding residential improvements. ( � �� K�„p�.,,�������
O�her land (z) F���* ��,-s�Y':
�:.':.r.�t''°tV�
Tdal land (line 1 plus line 2) �3)
�ay.4. ��: F-r v-_�y"F�
Dwelling (4) �y�.���� �����
Residenfial improvements �� �- ���' "
r - �s=. � �. =�s''r.` c-
Garage (5) ��}.�'-�✓� �-� 6.a.�� -.
.3.'b..x .,,��T•"�. n a�
Other improvements (6) €r-� �� �� ��
� � : �4.r��,,��
Tctal improvements (line 4 fhrough line 6) ���
Tdal value (line 3 phs line n (g)
I hereby certify the above is We, coved, and Signamre otnssessor oate signed
complete.
Verilyiiy actbn - SignaWre oflwditor Date signed
�`�^,��.v� �J�etrv�''�'':*�a-- �`.3��7��..�`;STANDARD'.DEDUCTION AL'COWANCE,.;�j'. ��;�„� y�°�� ;.�� n ��`1e"•`�����:�:�?�aRx.� �
20_Pay20_
Lesser o( 1!2 Homestead
Valuation or $6,000 5
Sgnature ot PLditw Date signed
�
Gibson County Audilor
101 N Main
PRINCETON IN 47670
1291
Curtis W Ritey
1793 E SR 64
PRINCETON IN 47670
S�VEf00.M VM11/!aMl
nrnsu�uwa�su
.liC:A'CEICH.I.L`11 �
IndividuaL. auJ ma;riN coupla are limitnf to oce home�eaJ �tandaN Acdu.iion. As thc �aript ol Ihi� dcdunicrn bcconree
mure beneficial. there is rtarc incrn[ne ttun ner for M1omeittaJ (rdW. Iloma:eaA fraud causes higher u� bills ior all; Nrrcfae.
HEA I3�13-3IXN rcquvcs uxpaycn x�ho recei�e the hanesteed <�ndard drAunion m rcrily that they arc cligiMc m mcene �he
benefii an1 to pnn'idr aJdiiional iJentiiyin_ infomut',on n ce.-.in� to allw� counp� gmrmmmt ro Y.tter mmirrn Iwmesead
filirk��. "Ihis informa�inn will be Aep conOJemiul and ren onlp M aare�sed by amMriu�f rounry olTmia�.. The Ik�wnnrent of
Lucal Gm�<mmcm Fivm�e will u.c ehis fnior.nacion io creue �uols tlu� aill h:ln rnmn' uffirial, <liminarc homcx�raJ fiaud.
Tasoarer Name Prnoert�� Addre
Riley, Curtis W/Tina L �
i
IL 13on119i
I
I'rinccwn 1��47E
State Parcel Number Leeal Descrii�tion
26-12-09-300-000.960.02 OOS-OO9s0-oo PT SE �S W 9 2 10 .95a AC
----. . .- -- --- - — - ------...---- -� � - ------
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county
na 1 First MidNe
C(,tf`i-lS I,�X�c�i�- �i I�C
ie Addmss (number end sum, city, stn�c, and ZIP codc) � Samc � pmperty a
9..3 �, S/� �v �/ /�r/�C e��i.f .;��N �71v 7
l�na �ou�se . ,��/��
lailim; Addre4 (�umber and snee4 �ry', staie, and "LII' cuekJ Samc as pmpe�
17�/� �. S�'L� `�0r /n1� e�an/ �i�/ �/ 7� TD
urer.
Each undersiened certifies, under penalN of perjury. [hat the above and foregoing infoRnation is we and cortect and that he or she is eligible to
receive the homeslead standard deduction on this property. Each undersiened also understands that, by claiming additional homeslead deductions
unlawfully, he or she may be liable (or baf;k taxes :uid substantial f nancial penalties �,_
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