Homestead_SweeneyCLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
State Fortn 5473 (R6 / d-03)
Presaibed by Ne Department of Locel Govemment Finance
INSTRUCTIONS: See ieverse side /or filirg inshuctans.
FORM � YEAR
HC10
� �
��e� - �� ���� r�� certify that on the 15t day o( March, 20_
I(VJe) occupied as our principal place of residence lhe following described pro y for whirh a Homestead P���� �r�� hereby daimed:
❑ I(We) owned ❑ We buying under contract
GIBSON COUNTY AUDITOR
� Have a benefidal interest in the enlity that is liable (or ihe property Wxes on Ne property and that owns lhe property or is buying under a wnVaU.
I( buy'ug om m�traq, Fee Simpie ownets name
Remrtlels ofice where conVad is remrdeA
Tawnship
e= oliaa
Taaing dislrict (ciry,
I 9,�10 . �os �"e
Record number � Page
❑ Mobila Homo (/.C. 61.1-7)
It any portion of Ihe residentlal sWCture w the land not exceeding one (1 � ava that immediatety surrounds that sWCture is used lo produce income, descri6e 1he use and portion
ot the property WlizeE to produce incoma.
County
Tvxnship
I hereby certify the above statements are We, corred and complete.
(number aM �t city, s(ate, ZIP code)
���'--����'`�� SSESSOR U E ONLY� ~' K��'� i'�RUE T��+�r � ASSESSED VALUE � HOMESTEAD� "`"''� NON-�RESIDENTIA���.'��
t?�-'�,f����p�.w.:=�-�Y'rs.l'1a's:?-�a ..,. %.i.`�'1 �,a ; �VAL.UE�ezC?.�5. pATq100 /a,OF 17V �-.�.VALUE�� fi..�ma-1�i.^m:"sVALUE a#..��.''�, ��
land not exceeding 1(one) acre immediately ��� ��� �':�'fi'�'��P�lY�
sunoundin residential im rovements ��) 4 't,�y{3 � S` "` ?
9 D :�'L-°rs ,.?��`-��P�r-t'�7n:;i"�"�r'�%-
z xY: �v- x
Otherland (2� ���t
: �" �?.���..�
Tdal land (line 7 plus line 2) (3)
- � 2 F Y,-:
Dwelfing (4) _ �,.�_�1,.���u�,���x�
Residentiel improvemenLS or Mnually `$0
C=
Assessed Modia / MantAactured Hame Garege (5) j� hi, c: ^` t _
�':�i�:: �aa�.K'
�.si�y �-,-�'T
Other improvements (6) �,.�,��
�� F
Tdal improvemenLs (line 4 fhrough line 6) (��
Tdal value (line 3 phs line n (g)
I hereby ceAify the above is W e, coned, and Signature ot2ssessor �ate signed
complete.
Vrrirying actbn - SynaWre of ALtlimr Date signed
20 _ Pay 20 _
Lesser d 112 Homestead
vawaoon a S35.W0
=p3-o�
tui[ fnlM.�wo�rz_ ��w� 1RF.�s�![R WRN �s�A
.pVN(Kf�I�YAqEBMPUMMCI:\ia.]�w YE6[RIBm�YTIfU[PARMEVIl4L(RAL:�hZLMF6ifP'A'CEICH.4E'J.I
Gibson County Auditor
101 N Main � � � ' � � � ' � � � � � � � �
PRINCETON IN 47670 IndiciduaL� and ina:ricJ aoupk� arc Iimi�eJ to ore homeucaJ aandaN JeAu.�ion. As ihc recrip� of �hi; deduciinn bacom�
mere beneficial, therc is morc incrn[i�x ihan e�er (or honxsie:Kl fraud. IlomeRead fmud cau.us hieher ta� Lilk for all; Ihemfore.
� HEA IiJ-1-1IXl9 requim mapasm who r.cei.c ihe hanestceJ cmndard JNuction to .erity tfut �hey am eliciNe to rceei.e thc
bznefi� aN ro p�w'ide aJclitiunal iJrntifi'mc intwmatwn Mttvan' ro allw� aounn� go:rmmeni eo berter mmrtor homesreaJ
�ilin�F. Ihis infomuiim will be Aqr ronfiCcniial and can only Fc aaresseJ M1y autMrizN cnunty n�i'¢iali The Ikptnnrcni of
I rcal Gwcmmrnt FivMC ��911 mc �his fnfortnatiun m cream rouls that �rill h:ln munn� ufficiaLa elimiwrc hom<>tcad frauJ.
0
ao»
Daniel Sweeney
R1 Box 173 A
PrincetonlN 47670-9358
�i�n��in�i��u�n����ni�i�nn��n�����n�ii�������i�������
�Av+; c � b�
Addrcss (numbcr and >vxc, ciry, smtc, and
iy�z o�� «wY
.
7�''Qm.� <A I AIVjJ
�iling Addrtv (t�umber and nvttL dq', s�a�e, anJ'LIP cale)
l 9 i, a o t- o! N w il ��So u
Prnperh' Address
�
RI f3u� U73 A
1'rinreton IN�47670
/�/b.� Olc( ��Y `��S
Le¢al Description
1122-00 PT NE 19 2 70 .605 AC
Swc;c,-wC��-
as D�aD�AV nU01ciS
Part 4
S cu e �e � �
]/Same as pmpeny adC
Pan 4
I` V
�
i
Each undersigned certifies, under penalry o( perjury, that the abo��e and (oregoing infortnation is true and cortect and that he or she is elieible to
receive the homestead standard deduciion on this property. Each undersiened also understands that, by claiming additional home�>tead deductions
unlawfully, he or she may be linble for hack taxes and substantial financial penalties. �
Owner I ture Us�c