HomeMy WebLinkAboutHomestead_Clark (6)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Stete Form 5473 (R6 ! 4-03)
Presuibetl by Ne Department ot Local Govemment Financa
IN$TRUCTIONS: See rererse side /or filirg insbuctions.
�� FORM
HC10
�����J
YEAR
��e) � certify that on the 1 st day of March, 20_
I(We) occupied principal place of residen th ollowing described real property for which a Homestead Pr�e}iy T�c C�, '1 is hereby daimed:
�.,
I(We) owned ❑ Ne buying under con ract GIBSON CO� TY Tf1
� Have a benefidal interest in the enli that is liable (or the ro e taxes on the ro e AUDI R
tY P p rty p p rty and that owns the property or is burng untlEr a wntract.
If buying om m�tract. Fee Simple owners name
RemrEers olfice whera coniraIX is recordetl
Nt••w�y �p,�i.�.^r N �� 4=��.-+�-'T�r�
County - Tamship
Parcel number
If any ponbn ol Ne residentlal sN
ot the proparty utilizetl to produce
\� �
w the land not
7rCI %�//l�
1 i�/� A I Is the
�.,,, a� rv. o a
rt.l�
one (1 � aae ihat (mmediately surrounds
/ �
Record number � Page
Iown, township)
Droperty ❑ MoDile Homo (/.C. 67.
is used to proAuce income, descn6e the use and portion
����,9t� AS5ESSOR E� N Y �-''Y��� ?��_s��TRUEsTAXr�-'�r ASSESSE�VALUE �HOMESTEAD� :�T�C+NON-F2ESIDENTWL�fj°� '
ix a:.�F'w3+ ..:.."� � �.,�9±�� +-�r�+}.�"',�ja�',S `�"sn-..VAI:UE�y C AT.i100%.OFTN,S �;t,_..�,:VAL'UE -,#"c: i .�g.iY7r�i".Y}SiVALUE����
Land no� exceeding 1(one) aae immediately a. ,, P�.�g�i'
suvounding residenGal improvements. (�) =,�'',��.�i��� �
, Y�..=2�.. .°��,� ��-;�
Other land �� �''���t.{,s`�, �
(Z) �.������ �
:.:-s�.n:�3:�: _z:4�t
Tdal land (line 1 plusline 2) (3)
�$,.; _ ,.�: �
Dwellin 4 ,��sx:,... ,+�'�,-�f;t y,: - " .� _ ^`-':"w'3
�ResidentielimprovementsorMnually 9 () �-�"�"'S''���x�'-���� � � ��y^�
Aasessed Mobile / ManufacYUred Hame Garage (5) �� ttfn������K�
,v�•:� �.Yr s < +
i�.a.'v �'>. -
"�'x'.-*-�ii1 �
Other improvemenls (g) �?g g1�2 � �-^ h
`'�� �
Tdal improvemenls (line 4 fhrough line 6) (�) _
Total value (line 3 phs line � (g)
I hereby ceAify the above is W e, corteG, and Signawre orAssessor oate signed
oomplete.
Veritying aclion - SignaWre otAuditor Date sgned
', s:. -f5• r2:��"°`f1+s�rr�3�k,Yi�: ' ' � �..,.,.� � .i.: �'4i' .' ' � � "��.3:1.�i*�_�l?'o-'�°�`Se
-_ . . a�:�� r +�-�,n,.�-F�._"*tT�" .�n.- .nx . "'�e.aSTANDARD;DEDUCTION'AL'LOWANCE�:�,y,.z,tq;� , � �,��E.y.�„K.g�:�e,�`4, .
20_Pay20_
Lesser of 1/2 Homestead
vaWanon w E35.000
S
Signature of Auditor � Date signed
.•
Gibson County Auditor
101 N Main
PRINCETON IN 47670
2360
Gary Clark
1614 Brentwood Dr
PRINCETON IN 47670-3318
[�iR101LVa�ywlM_/!V�1
nr.�v:uxwav:su
InJividuals and �rt�:riN couplr: arc Iimi�N io onc homcvcad yand'nN JrAuaion. As ihc �ttctipt ol �hi> Jitluction bcconres
morc benencial, therc u marc incrnm�r chan e�er (ur homesiracl fraud I IomcveaJ fmud cau.es hiahrr Lia bills for all: thercfae.
H!A 131i-7(1(19 rcquvrs �apa.m ..�ho rcccivc Ihc hanevcad st�ndaN Jcyfunion iu .eril4 tha� �hcy am eliciMc to recei�c ihe
benefi� and �o pnn'idr a�Witimul iAeniiiyim_ infumt�twn Mas'vn' �u allox' counp' ea'rmmenl �u Y.tter rtronitw humeste:rl
filin��.'Oiis inlnrmatim will M 4.ryw cmlidttuial and rrn nnly ha acccx.eJ Fy amhnrv<J rnunry n(TKiuls.'I'Ar Ikpanmm�t o(
Lucal Gw<mmeni Pmanm �vill m< �his information W cream twls ihat will help county uhTicial.' dimmah homett<aJ tmud.
. � � � � �
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Taxnaeer N•ame
Clark, Gary/Kimberly
Stale Parcel NumAer
�f 26-12-06-401-002.361-028
Propert�' Address
�b�i �3MIIIN'(Hll��)H
Princemn I� 47670
Leaal Description
019-02361-00 NORTHBROOK HILLS 19