Homestead_SlagleCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� State Form 5473 (R6 / 403)
Prescribed by tha Department of Loral Govemment Finance
INSTRUCTIONS: See reverse side lor filing instnxtions.
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FORM YEAR _
HC10
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��e� N certify lhat on the 7 st day o( March, 20
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I(We) occupied as our principal place of res�dence Ihe (ollmving d s bed real property for a Homestead Property�7�i�CrediCis hereby daimed:
� 1(VJe) owned ❑ Ne buying under contract GIBSON CC t:T�� FU���TOF
, Have a benefidal interest in the entiry that is liable for the pmperty Wxes on the property and that owns the property or is buying under a conVaU.
If buyug rn conVad, Fee Simple owners name
Recordefs olfice whare conVaG is recorded
Tsvnship
Tating dislricl (city,
Parcelnym��� �//�, / _1Le9aldescriptiop � f/1/� / 9 Lll
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N any portion of the resitlentlal sWCWra w Ne land not axceeding one (1) aae t�at immediatey surrounds
af tha property uWized to produce income.
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Record number
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Page
91 pmperty ❑ Mobile Homo Q.Q 61.1-7)
is used to pratluce income, describe Ne usa and poNOr�
20 _ Pay 20 _
Lesser of ti2 Homestead
vaivauon w 5�5.000
S
Date
I.-1
. SLUE FORM 5156<(IU /410) '�.�51,'RF3 F00.H�SIA
� MYRR'iDB\'SGiEBWMOfA[[ThIYlS.IIW I0.ERRIBmBYl11F.Od�R1ME�'IOFII%'.U.IXNkR�NEYfFlHA`IffICI�.I.I-'3d.1
Gibson Caunty Auditor ' � / � � � . � � � � � � i"rfYiii'i
101 N. Main SVeef - � i„df��d�i: a„d married muplc� aze luuittd ro�one homcctead sraniL�rd Jeduction. As �the receiyt'of this deductioo hecomes
PfIf1fR200, IN 4i6�0 - morc bcnt(tial, there is more incemi�x Ihan iti�er for Iwmestcad fnud. Homestrad Gaud waus highcr tax bills far all; thcrefore,
HEA� I3J4-?009 rtquires tacpa�rrs aiw recene the hamestcad standard deduclian to �xrifi� tha[ �hey arz eligi6lc to receias ttrc
• F I L E D�efit end to prmide additimul idrntif�irig infortnetion neccssery m ellw crnmry grnemment t�i bener moniror homestrad
filings. This infortnacion will bc kept confidrn�ial and can only be acccssed by authorircd county c�f5rials. 7hc Ucparm�cnc of
l.ocal Gmromment Finance w'ill use ihis information to aeace tools that witl help munry officials'�dimi�te Iromestwd fraud.
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_ APR 8 20fl
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GIBSON COUNTY AUDITOR
594
Kevin M Slagle
2020 Petersburg Rd
Taxpaver Name
Slagle, Kevin M/Sandy D
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I II�I�III��III �II�I �
�no N MEtN sr
PRINCETON IN 47670
IIII��II�II�III �II�III�II I�II �Il�llul�l�lll IIII -
PRWCETON IN 47670.8665 I '
II�'I'�I�II�I�'�I��"I���'�I�'I'�III�'I���'��'ll"��'�II"I��'�'� State Parcel Number Leqal Description
. � � 2612-06-203-001.154-02�PTNE6210.2.337,+C � D-7
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This form-MUST be returned to County Auditor's office. ;
Please do NOT send this form back with your tax payment to the coun,ty treasurer.
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iling Addccss (mtmbcr nnd stm�t, ciTy, statc, and ZIP code) � �"Seme es property add
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:ial5e�viiry N�bcr (last 5 digits) Drive�s Lireusc/Statc ID N�bcr (last 5 digi6) Othcr (please spx
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( 2ZG /�„dlti-a S�
:ial Security Number (latt 5 digiu)
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' c ai properry address`
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Od�er (ptcbce spec�ry in Pan
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nndersigned certifies, under penalry of pequry, that the above and foregoing infortnation is We and cortect and that he or she is eligible ro
re the homestead standazd deduction on this property. Fach undersigned also understands thai, by claiming additional-liomestead deductions
�fully, he or she may be Gable for back tases and subs[an[ial financial penalties. . � .
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