Homestead_Smith (36)ME R���
e�/ =' °g CLAIM FOR HOMESTEAD PROPERTY TAX
i��;; CREDIT/STANDARD DEDUCTION
.�„�' Stare Form 5473 (R2 / 5-92)
�eL
INSTRUCTIONS: See reverse side tor liling in5fructions.
FORM
HC10
YEAR
�
�e) _,H-Q"Ji l. 71/�JJ�(^t/,CG( l� //!7/� /l, certify that on the 75t day of March, 19_
i�We) oc i d as our principal place of re dence the following described real property for which a Homestead Prop Tax CreditLLS h� br� y yly'�ed:
,c1 . �,�a,�
S I(W owned ❑ Are buying under contract - . AUDITOR
❑ Have a beneficial interesi in the entiry that is liable for ihe property taxes on the property and that owns the property or is buying under a contraci.
.- CONTRACTRECORDED � - � -- � .
If buying on crontract, Fee Simple owner's name ' � ' � _ -
Fecorder's oRite where Contract is recortled Record number Page
Couniy
Parcel
6.4 Xa—LA�(�� J-
If any portion of ihe residential sirucu
of the property utilized to produce inc
Township
oriheland
PROPEHTY DESCRIPT N "
T" g stria t(ci , town, fawns rp) .
�f �
�� �-s �- /�n �
one (7) acre that immediatety surrounds thai structure is used ro produce income, describe t�e use aM portion
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE � VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately
su�rounding residential improvemenis. (�)
Otherland (p)
Total land (line 7 p/us line Z� (3)
. Dwelling (4)
Residential improvemenis
Garege (5)
Oiher improvements (6)
Total impmvements Qine 4 through line � (7)
Total value (line 3 pLs line � ((g)
I hereby ceRify (he above is irue. correct, and Signawre of Assessor Date signetl
mplete.
,�ying action- Signature of Audiror Dare signed
19_Pay19_
Lesser of i/2 Homestead
Valuation or 52,000
STANDARD DEDUCTION
S
Dare signetl
` _ lliiEf[1RN!�W�2'/Nr� IRFAS�:AERf00.MYlA
e�Mn'FI�BYSIS¢E(MPD6M�[G�Ti9x PLfdR10m01'illlUBMMLVifiLIX'AL[TE0.V4RTiII:A9CE1CH.1-S]JJ
Gibson County Auditor � , � � � � � , �' , � , �
101 N Main
PRINCETON IN 47670 �ndiriduaL. and rturriN coupks arc limi¢d �o orc homes�raJ �andaN �LNu.iion. As ihe reccipt oi �his ileduction becwx:
merc beneficial, there is marc incemne thm eccr (ar humesrcad fnwl. Ilome>reaJ faud causs higher ta� 6i;li for all; thercfae.
� HEA 13ii-2Uo9 requ'ues m�pa�en wlw reeci.r the hanestceJ s�anda�d dNuction m v<rily �he� the. �re d�_iNe to mcci.e ihe
benen� ani tu p�a'iJe alUitio�ul idrnuiyim infurm.irun nea: mn' ro allw� counq� go.�emmmt �o bener �.mwitw homrnraJ
fili��. Ilii� intmmalion will 6e 4.m1 cwlidemial and rvn nnly h� acce.uuJ by aWhorimd ronny' o0icinlx.jl'he Ikpanmem nl
I.ceal Gwcnvnent Pi�unm ��ill u�< Ihfs information w aream hvlt tiwt �rill hdp cn�mn' offirials dimmak humesteml fmuJ.
���
James A/Margaret A Smith
941 S Deerhaven Dr
PrincetonlN 47670-8855
I�I��II���I�II��I���III���I,�I�I��I��I�I��I�I��I��I���II�i�l�l
Taspecer Name
Smith, James A/ Margarel A
R? Doa 253 D
" — i
Princclon 1\ �iifii
Stare Parcel Number Le�al Description
2612-15100-000.620.027� 006-00620-0o PT NW 75 210 7.086 AC
✓ i
��1� i
�
i
I Rrsi
��R����� A�N
g Address (numbcr m�d iveM, ciry, sWic, end ZIP codc) � � ���
9�/ .S 1���62�fi-U� 17r�/l/�
�
�c'�cr�°d I
.4ddre� (Number and streel city, staie, und "LIP coJe)
(las[ 5 digits) � Drivcrs Liccnsc/Statc ID
�,�Ti;
Some n> pmpcm oddrec.
in Part 4 bclow)
� Sune a� pmpeny ad�;
spcciF in Pan 4 bclow)
�
,
-+ - -
undersiened certifies, under penalry of �pury•. [hat the abo�•e and foregoing infoRnation is we and co�rect and that he or sBe is elicible ro
:e the homesiead standard deduciion on this propeny. Each undersiened also undemands that, by claiming additional homeuead deductions
+fully, he or she may be liable for back taxes and subsiantial financial penalties. _ �
0
��
-
� )