Homestead_Shepler""' CLAIM FOR HOMESTEAD PROPERTY TAX
- _ � CREDIT/STANDARD DEDUCTION
State Form 5673 (RB ! 7-07)
•� Hu 1 Prescnbetl by �ha Deparimeni of Latal Government Finance
INS7RUCTIONS: See reverse srde /or filing instn�ctions.
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I(We) �'/lJ2�C',(1/Y�[�(/ L�/C.Q�C� certfy fhat on [he 7st day of March, 20_
I(We) occupied as our prindpal place of residence Ihe �ollovring described real property for vfiich a Homestead Property Tac Credil is hereby daimed:
,I(We) owned ❑ Ne buying under contract
Have a benefidai interest in Ne entiy ihat is Iiabie fw Ne property taxes on the property and that owns ihe property or is Wying under a contract.
If btryinq am m�Nac� Fee Simple ownefs nama
conlraa is recortlad
Cwmry
Tamshlp
Taing dislncj�(Q'IIy, to:m, focroship)
Record number ' Page
Parcel number Legal tlescnption �� �� I Is Iha property in question:
❑ Real proparty ❑ Mobiie Home (IC 67.7-�
If arry porGon of the residential sVUCture or the land not ezceeding orre (1) acre that immediately wrtounOS thal structure is used to produce income, describe the use and portion
of U�e prope�ty utitized tn produce incwne.
a�-�a-o�- vo�-oov. -�33- o��
,_ . . . .. . .
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Land not exceeding 7(orre) aae irtmedia[ely � , . � ��
surroundirgresidentialimprovements. (�� . . � � : -� �
ONerWnd �p� � .' ..
Tda� land (line 1 plusline 2) (g� �
. r c.x �
Dw¢Ifirg (4) y ..��,
Residential improvemenis or Mnualy I- r �... . "L �-`
Assessed Mobile / ManuFachired Home � - -, . .
Ga2ge (g) � E,... �,:�ti.-,_=-;.', :;�1.
Other improvements (6) � � -
Tctal improvements (line 4 fhrough Gne 6) �7)
Tdal value (line 3 plfs line n (g� �
I hereby tertify the above is We, correct, and signature otAssessor oate signetl (monN, day, yeer)
compiete.
Vaifying aaion - SignaWre aflwdimr Dxte signed (mmN, daY. Y��)
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PaY ZD — 45,000 for 2007 pay 2008 42,000 for 2010 pay 207 7
Lesser M 1l2 dq.ppp for 2008 pay 2009 47.000 for 20N pay 2072
Hmnestead Vaivation $
w 43.000 for 2009 pay 2010 40,000 payable after 2012
SignaWra of fwditw Dale signed (monN, day, year�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
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A��RlT'FI�flY�i�iEBMpplliVY.��TTi.9ia PAf3AiHmBTiI�IUEPMT�Vi(flQ�1lC�LW..f�.TTA\CFN'LII�LJI
IndiriduaL. and ma-riN coupk. are limi�ed �o cme homz.�ead �tandard d�ut�ion. As ihe reccipt ol thi� dcdunion bttmx:
murc beneficial, there is morc incrn:ne than e�er for home>�eaJ frauJ. Ilomo�raJ i(a�a1 caases higM tu 6ills iur all; �he¢fae.
HEA 13�ti-?IX19 rcquirn �a�paren who rceivc �he hcwnestraJ s�andard dnlunion a.erilv th+t �Ae}' art elieide w mcc'ne ihc
benefii ani m pnxide a�Witio�ui identiirir_ fnfwm�iiun nem'vrv �o allw' counn� ew�emment �u betrcr muniror homesre:d
filin��..'Ihi� inlo�ma�ion will M Aqw mnLdrntial and can only Ix: acn�.n1 M1� awMri�nf ronnry� n�cinls. "ITr Ikpanmm�i o(
Taxnacer Name Propem� Address
Chandler, Melanie N
— ieio ore�i��
1'rinreton I\ 47670
2351
Melanie N Chandler
1610 Brentwood Dr State Parcel Number Leeal Description
PRINCETON IN 47670-3318
I I II I'I I III II II III I IIII II I �( 26-12-OG401-000.733-028 01&00733-OONORTHBROOKHILL518
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(numC�T wid ilnxt, ciry. >Ietc, :�nd ZIF :w.j
ocel Securiry' Numbcr (last 5 die�u) - Drivcr's
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c IU I�mnbcr Qasl 5 digils)
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� Addrcss (Number and av¢4 �i)', smie. and "LIP cale)
Cr� / U, r� vc�d i'�` i/e
Security Number (lazt 5 digits) Drivds LiccnulSCatc ID Niunbcr (laa 5 digits)
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��7�n�/�P r �
c. pmpeny
Oth<r (please specifv in Part 4
��hepler
.. IC�I Same u pmperty addrai
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Ochcr (plcacc spcciC�� in Part?
idersigned certifies, under penelty of �rjury•, that the abo��e and foregoing infortnation is we and wrrect and that he or she is elieible to
the homesiead standard deduction on ihis property. Each undersigned al>o understands that, by claiming additionai homestead deductions
dly, he or she may be liable for back taxes and substantial financial penalties.
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