Homestead_Clark (6)�,..,.,.
a ; CLAIM FOR HOMESTEAD PROPERTY TAX
;���� CREDIT/STANDARD DEDUCTION
.�,�� � State Form 5473 (R2 / 5-92)
INSTRUCTIONS: See reverse side for liling instructions.
FORM
KeSO e
�. , ��_}�-
��� 191995
YEAR
�S
,,�.y+�"
' „Ne) � ����,�, ��yl�e t�sC�tl3y of March. �9��
�e) occupied of residence Ihe following for which a Homestead Property Tax Credit i5 hereby Uaimed:
L� I(We) owned ❑ Are buying under contract .
❑ Have a beneficial interesi in the entity that is liable for the property taxes on the property and ihat owns the property or is buying_under a contract.
. � CONTRACT RECORDED . - • - �
If buying on tonVact. Fee Simple owner's name
Recorder's oflice where contract is recorded Record number Page
Counry
If any portion of Ihe re5id
ot Ne properry utilized to
PROPERTY DESCRIPTION
Taeirg diSVie� (eiry. town. township)
legal description
> � �: �1 �,) a! �: \\ � _ �.0 ��s(J
or the land not exceeding one (7) aae ihat immediately surrountls mat swcture is used to produce income, describe ihe use and portion
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES � �
Counry Township _ Couniy Township
� ieby certify ihe above statemenis are true, correct and complete. Signa re of aai � / '
.G�-
Address (number and street. 6ry, sta(e. ZlP code) '
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
:VALUE VALUE� VALUE VAIUE
Land not exceeding 1(one) acre immedialely
surtounding residential improvements. - ��) "
Otherland (2) �
Total land (line 7 plus line 2� (3)
Dwelling (4)
Residential improvemenis
Garage (g) � -
Other improvements (6) .
Total improvemenis (line 4 through line � (7)
Total value (line 3 p�s line � (g)
I hereby certify the above is true, correci, and Signamre of Assessor Dare signed
complete_
"ying attion - Signature o( Audiror Date signed
r '
79_Pay19_
Lesser of 1/2 Homestead
valuation or 52,000
STANDARO OE�UGIION ALIUWANGt
S
of Autli;or �1 . _ . . � Date
�
�--
Gibson County Auditor
101 N Main
PRINCETON IN 47670
n.a[rozm.�v+��iw.i
iarnsuitv rutiv au
InJividuaLa and nurrini coupk. arc Iimi�M w onc hnmt.acaJ uandaN dnlu.�ion. A> �he rtteip� ol'this JcAuninn Mcome�
merc beneficial. thrrc i. morr incrn(ne clun e�er for homoiesl fr�ud. Home.rc:�J fiauJ causcs hi�her �aa bills tur nll: thr¢fne.
HEA 13i�1-?IX19 requim laxpa�en who receive iM1c hanest.rod st�ndard dnfunion m verify du� �M1ec are elieiMe m mcei.e �M1c
beneni aN iu piw'iJc :rkliiional fdrnniyinc infurma�ian rmcYa'vrv ro allw� euunn gm'emmrnl ro N�rer mmitur Iwmrne:d
filin�. Ihis in(mmatinn will br Aryv contidential anA nn nnly h: ucesatl hy autMriiN row�ry' n�cial.. The IkTannxnt of
Lucal Gm<nvn<m Pinam�c ��ill uc this iniomwtion cu trcau �wis ihat w'ill h:Ip awnry officiaL. dimina�c Iromn!;ml fraud.
� � . � � �
Tasnarer Name Properh� Address .
Wagner, Kerry / Theresa I nI�`l��
Rr3 6ox 105 1 l� /, /
!'� � %/
Owcnsrillc IN 47665
1984
�- �qr �
J4� / Theresa YMeeJner
4330 W 200 S
Owensville IN 47665-9156
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State Parcel Number Le?al Description �
26-11-21-100-001.237-027 OOfr01237-00 PT NW 21 2 it 6.02 AC
D-17
nc Addtcss (numbcr ond svttt. city, smtc, and LIY <odc)� — — �— -- -- ' ' - -'
� 33 0;,� a oo s QI,� �i�s�il� -�l�1 `fl 4l� S- ,
�ilip�4ddreSti (Ihumbcr and stree4 cii)', sWlc, and "LIP code)
� 330 � afl� S t��le�nsv� il�
cial5tturity Numbcr (las S digics) Dnvcr's Liccnsc/Sum ID Numbcr
� � �.-�j
��
, . , �
� _.
pmpcm� x'Er� _— —
in Part 4 bclow)
�e u PmPem add�a;
S/t1 %� l � S`
spccify in Part 4 bclox•)
Fach undersigned certifits, under penalry of �rjury, that the abo��e and fureeoing infortnution is we and correct and that he or she is elieible to
receive the homes�ead standard deduc�ion on this property. 6ach undersi¢ned also understands lhat, by claiming additional homestead deductions
unlau�fully, he or she may be liable for back taxes and substantial financial penalties.
Owntt J Si�matur< — �' - '' - Untc � � - -- � - 7'dephon: � — . .
��I��.�.��ua� y_ao-� o (�
� $