Homestead_Smith (27).�
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
� CREDIT/STANDARD DEDUCTION HC10
` �� Sfate Form 5473 (RS I 10-07 � r+,�
��� Prescribed by the DeparhneM d Local Govemment Finance �� ��� .
INSTRUCTIONS: See reverse side /or filing instructions.
I(We) _�� ' 1 �_�.{..LA\ r � � c`e�i�tiry�at on the 1st day of March, 20_
I e occu ed as our rind I lace oi residence the followin described ren"� � �
(W ) W D Pa P g arpr��ry.j fm�wfi'�a Hoineil��d" roperty T�c Credit is hereby daimed:
❑ I(We) owned ❑ Are buying under wntract '' G18S01J COUNT Y FUDI i OH 1 .
� Have a benefidal interest in the entiry that is liable for the propeRy taxes on the property and that owns Ne property or is buying under a conUad.
I( huying on conNaq. Fee Simple owners name
Remrders ofice where coMraU is remrdetl
Caunty � Tamship � Tacing d'aUict (riry, tawn, (ownsAip)
Racord numEer � Page
PV V��� �/J `� �� I L�dZ.V7�� ' Y �'lO .��Is the pmpeO^Real WoOeM ❑ Mobile Homo (I.C. 61. f-n .
N any ponion a1 Ne resiEenllal atrucLue w Me d nd ezceetlinp ona (1) arfa that immediatey wrtounds thet sW uure is used b produca inmme, desaiba Ne use antl portbn
of Ne pruperty Wf¢ed tn produce income.
�{` � 'S�"°�'-�'x�r-���� ^t°�y.``� �.-s . _ "� . . . n�'_...., .,,� - - � +� t
ASSESSOR�l1SEONLY `i �k -�� �i�'i.y�UETAX'-+� - ASSESSEDVALUE �HOMESTEAD� .'�` NONAESf�ENTIAL �
�.0 ���,.���x,�..,��.��T,«„'��VALUEyS„� r _ATi100/zOF�TIV� �'1�,VALUE�4a � ;�°.��VALUEvY?s��
Land nol exceeding 1(one) aae immediately (' � ���� ����.���-C�� ��i�
sunounding residen6al improvements. _ � � � ,
Other land �,�����j'��"'��
(2) .,Aar`.'s�?.�i...�
Total land (line 1 plus line 2) (g)
�-�.�.;^�,�....; . �- zrz �- �t�''�-
Dwelling (4 � � �i �' � �^' k.s,� r .
Residen6al improvements , �� � �� � � Y
„- �.} . ,�,,:r .- �� r
Garae �� �. `
9 5 ? i ��
�. `,,.- u.'�.�. ' 3.. $ �p�_ �,.�+�',.f_�i
Other improvements (6) ��L�� �
?: �'3:: `�'���
TUaI improvemenLS (line 4 through line 6) �7�
Tdal value (line 3 pha line n (g�
I hereby certify �he above is We, corred, and SignaWre of Assessor Data signed
mmplete.
Verifying ad"an - Synature of PLtlitor Date signed
•
Gibson County Auditor
101 N Main
PRINCETON IN 47670
3895
iUR fOR\I!!'Altil )WI
1i� _
IAF. SllRER W0.V :SIA
IndividuaL and �rt�rriN coupla are limi�cd io ore home�csJ �andaN JNu.�ion. As thc rttcip� of IhG dWuction hccm�e•
mure benencial, ihrrc is morc incentnt tlun r�er for homeNeaJ fiauJ. Ilome>tta�l fiaW causes hinher tac Eilli ior ail: therefore.
HEA Iiii-?009 requim u�pacen v.ho ra�ceive Ihe hanest.aJ s�andard JeJuction �o veri(y tha� �hey are>IiciNe to rccene �h.
benent an1 ro pnn�ide a�kli�imul identifi'inc infwmauon �xar'vn� ro allw� caunp� grnrmmrnt eo Nner mmiror IamrneaJ
filfn� .'Ihis inlnrmalim will hr Aqa emfJeivial a�d ean only M arce: w.f br w�hnrimJ rnunp� o(i'¢iat�. The De{�tnnxm of
�
Lueal Gwcmm<m Fi�u�rce will ux this information ro crw[e hule �ha� will heln eounn� ufficia� dimiwrc hom<stcml traud.
Kevin P Smith
76E150S
Frinceton IN 47670-9273
���u��in�i��u�ui���ni�i�nn����ni�n��i�ni����uu����
— IOxner 1 Fi
e�h
ie Address (numba und �o-cc4 city, smte, and ZIF
7l E /5 d5
�
Addrcsti (Number anJ strtt4 cily, siale, and ZIP code)
Sccuriq� Numbcr (lact 5
Uher (pleasc specify in Pan 4
� S;une :u prapeny ad�Less
pas� 5 digits) � Otha (plcasc +pccify in Part 4
mdersi�med certifies, under penalty of perjury•, that the abo�•e and forecoing information is we and cotrect and that he or she is elicible to
e the homes�ead standard deduction on this propeny. Fach undersi¢ned al>o understands tha� by claiming additional home �tead deductions
fully, he or she ay be liable for back taxes and substantial financial penalties. �
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SipuNre ' Ua[eV I�aepmne � � �