Homestead_Rister�t n�p4
a� �, CLAIM FOR HOMESTEAD PROPERTY TAX
i��'� CREDIT/STANDARD DEDUCTION
.�,`�� State Form 5473 (R2 / 5-92)
�eu .
INSTRUCTIONS: See reverse side 7orliling instructions.
' ' • ' C TIFICATION STATEMENT � -- -
�(We) _ . . certify
'e) pied as our principal pla e o residence ihe tollowing described real property for which a Homestead
ttt J I(We) owned ❑ Are buying under contract
I❑ Have a beneticial interest in the entity that is liable for the property taxes on the property and that owns the
I
It buying on contracL�Fee Simple owner's name
�Recorders oHice where contract is recorGed
•'/ �= :
LL
MAY 1 � t.o,g�
�perty or is buying under a contract.
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. �.�u(']SI�iV i'".�v TY h�U�'I�Fi
Recortl number Page
- � � rnVrtnirutac irnVn -
Counry ' Township . Taxin di r „ wn, nship). � ,
e um Leqaldescription �
If any portion of Ne res' ential swcwre or the lantl not ezceeding one (i) acre that immetliatety wrmuntls ihai structure is usetl to produce income, deusibe Ihe use arW portion
ot ihe properry utilized m protluce income. ,
� PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES -
Counry Township Couniy
reby certify the above statements are�irue, correci and complete. S" re o� Uaimant r� �
�•
Address (num6eiaMStreet, dry, sfate, ZlPmde)
R.R#a Qoz z� PR�tic��N, �N.�,��a
� TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL .
ASSESSOR USE ONLY � VALUE VALUE VALUE VALUE ��
Land not exceeding t(one) acre immediately -
surrounding residentiai improvemenis. (�) "
Otherland (p)
Total land (line 7 plus line 2� (3)
Dwelling (a) �
Residential improvements
Garage (5) � .
Other improvements (6) -
Total improvements (line 4 thiough line � (7)
Total value (line 3 p�s line � (g)
I hereby certify lhe above is lme, corrett, and Signamre of Assessor Date signed •
complete. �
fying aaion - Signamre ot Autlitor . Date signetl
�
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
219
1PFASU{[It1ORV 11�
PGEAF�Bm�YTiE
IndiviJuals aud rtu,-riN couple� arc limimd �o ore homeycad �andard ANunion. A� ihe rttrip� ol' �hi, dedunion bttomes
mo�e beneficial. there is morc i�enmx tivin e�cr (er M1omes�ead frdud. Home�eaJ faud cauks higher uc liills for all: th<rtfore.
HEA li4-F-'_UW requim u�pa.ers xho reccire i6e hanmmd smndard Jeiluction w verifi� tha� �hq� are eligiNe io rteene ilre
benefi� and to p�a'ide additiu�ul idenuirfnc in(ormation riecrvan� to allw� eounp� gm'emment �o bzem� muniror homes.ead
tilinF,�. Iliis iNUrma�ion w�ill M kep conL�icntial and e�n nnly 1x arcesseJ by awhorizN cannty olTciak. The Ihpanmen� ol
Lucal GmemmcN Pinance afll u« this in(ormacion m crcatc Iwle that will h:lp cvunn' ufficials climirarc hom<iicad frauJ.
David K Rister
2779 E Top Hat Rd
PrincetonlN 47670-8851
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Taxnaver Name
Rister, David K
� �sor zss
Princemn I\i�7670 ^
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State Parcel \umber Lesal Descnntion
26-12-15-100-000.402-027 006�00402-00 PT NW 15 2 10 2.246 AC
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er 1 F�rstl � m
fJ f✓ v� p /r� � rH
lig Add�s (numbcr end �rieet, ciry, siate, and�Z1Y cade)' - - � -
� � 7 � � roP /fffr RD. Plern�c,�To�v
J$ecurity Number (last 5 dfciLC) Drivers License/Sute ID Nmnbcr (lui 5 diviB) Other (F
TRic I/j
LAv�Rn�E
iline Address (Number and strcet, ciiy, state. and ZIP cuik)
�'1 Z q E ToP 1��9T R p PR��v C F ro•✓
:ial5tturiry Number (last 5 digia) Drivers License/SU[e ID N�unber (la.� 5 diei[s) Oefie
/t i s r� �p
_. 'O Snmz m pmpcm adLr�;
/,v �7G7D
�i s r�-�
� Samc u pmpem add�a,a
/N, � i�'70
Iasc s�xciN in Pan 4 bclow)
mdersigned cerrifies, under penalty of perjury•, that the abo��e and foregoing infortnation is true and cortect and that he or s�ie is elieible to
e the homeslead standard deduction on this property. Each undersigned al>o underslands lhat, by claiming additional home>tead deductions
fully, he or she may be liable for back taxes and substantial financial penalties. I
1 Signevm Da�e '1'clephme �
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