Homestead_Selby/
N� . CLAIM FOR HOMESTEAD PROPERTYTAX
' CREDITISTANDARD DEDUCTION
� � State Fwm 5073 (R4 / &00)
INSTRUCTIONS: See reverse side (or filing insUUClions.
FORM �R YEAR
HC70 O
I(VJe) certify t�� tlie �'st��af March, 20_
I(We) oca ed s our principal piace o residen the following described real property for 'ch a Homest d Property Tac Credit is hereby daimed:
�I(We) owned ❑ Are buying under contrad
iave a beneficial interest in fhe entity Nat is liable for lhe property taxes on the property and that o t�e� `�, u��a� � ntrad.
�'"��'� '�'�`��'�"�'��"°-_.._, , � GONTRACTiRECORDED� �� �-'�.. -�'�'��",��'�' ,A �-' r
r �"�'r��_�'--. �.«__._ _ rbi� ''�`'"�?:�-s.�. �.�,:I'_h'��
II byvg on wntraU, Fee Simple ownefs nartre
Recordefs oR¢e where contraG is recorded - ' - ., _ Record numher � Page '
Counry
II any portioiTOl iheTesidentiai s Wclure a
of Ne properry uWizetl lo proCUce income.
Tavnship
Legal tlesaiptlon
rrot
(city, town, fownship)
(1) acre that immediatey surtountls
at swcture is usetl to produte ma
ihe use and portion
�
•
Gibson County Auditor
101 N Main
PRINCETON IN 47670
0
tIUE RIRN!"M IIC' / f�wl
.V�RfT E11 Bl" ci\lE YNRDT.V�YYI\Il9w
tRE�.NIRfORV :SIA
h�diviJuals anJ irturieJ aouplo are IimitN to one hnmcuead �andaN dttlunion. As �he rtteipi of �hii dcrluaion baeomen
morc beneficial, thrrc i. morc incrntice than e�er far homestesl fr�ud Iiomes�enl fnuJ causes hieher tac Iiills for all: thercfae.
HEA I±11-�f109 requim uipa�ers who retcirc �M1c Iamcs�raJ <tanduJ JcJuction io .erilv ifut �hey am clieiNc m mcciw ih.
bznefi� am1 m prw�iJ<:xlJitional iJentiiying infumu�nun nem'vry tu allw� aounq� gmrmmrni ro Y.ta� moniror homrsrc:xl
filin��. This informalion x�ill hr Aryv rnnfidemial and on nnlr h� ntre+�eA M1y aulhn�ireA rnum�� nllicial.'. �I'he Ikpannmm of
Local Gm'emmem Pire�rce eill uu Ihis fnfofmation w crea:c ttwls thm will h:lp cow�p' ofFciaL. dimir.erc Mimnrcml fiaud.
1936
Robert A Selby
1198 S Hoot Owl Lane
PrincetonlN 47670-8147
�i�u��ni�i��n�ni���ni�n�nu��i�n��n���i�u�n�i�i�u�
Taxparer Name
Selby, Robert A/Beth A
1193 S Hoo�
Princeton 1
State Parcel Number Lej_al l
26-11-16-400-003.937-027 6-03937-00
D-17
(number nnd sVCCL city. smte. and "LIP'code) —' ' ' - � n ' —' " — � � ' �' :wme ui pm�xiy od.�c,�' —
Addresti (Number anJ 51ree4 cil)', siale, and ZlP code)
I�ne
HILLS 18I19
�igned cenifies, under penalN of perjury, that the abo��e and foregoing informatiun is we and co�rect and that he or she is elieible to
p�mestead standard deduction on this property. Each undersiened also understands that, by claiming additional homes�ead deductions
he or she may �able r back taxes and substantial financial penalties. �
�m.. . li Ualc Tcltphme �
5-7, D �