Homestead_Clark (5)Gibson County Auditor
101 N Main
PRINCETON IN 47670
��
3344
0
mr ciexroti�:w�
Indi��iduaL. anJ rturriN coupk.+ arc limi�ed �o orc home�nJ yaMaN dMunion. As �he rmtip� oi ihi> dcdunion 6aconm
marc beneficiai, therc is morc incenme Ihan ecu (or homurcad frauJ. Homo'teaJ fr.ua1 causea hi�her bc bflls (or all: ihercfae.
HEA 13�1-i-?C09 requims ucpa�ers x�ho receire ihe hanes�eaJ standaW JNuction m.erity that thz�� are cligiMe to rceei.c ihc
brnefii anl to pN�'ide :ulAiliUn:il identiiying Infomiauon necrs'vry to allw� countr gm'rmmmt �o Y.Iter munitor homrnead
filinb-. lltia inlormLion will M Aryu eontidential anA tnn nnly M� ateexaed M1y authnriznl counly nfliciols.'fAe Depanmem of
lucal Govrmmrn� Pi�uMe will ux this information w crea[c h�ols that �vill h;lp cuunn ufSdaLS climfnTC Iromesrcad hauJ.
. , ' , , , ,
' T•uxpaver Name Propert�• Address
Clark, Rollie C / Cathy
Rollie C / Cathy Clark
1409 Jeftersan ST
PrincetonlN 47670-2917
I�I��II���I�II��I���III�����I�II�I�����III���III���I�I��I��I�I
�tf�
lig Address (numbcr ond >ami_ ciry, starc, and ZIP codr)
��j fErFCR�Son� �ST.
I Sceurily Numbcr (las� i dieils) Drivtt's LicaudS�ate ID
�
Nee4 cilp, sWle, anJ'LIP cak)
cC�2�oti S% _
1�09 leiTerson S7'
1lincewn IN 47670
S[ate Parcel Number Leoal Description
X 2612-OS-400-000.423-028 Ote-ooa23oo Bn�DWIN HGTS 2 BLK 5
Cl�x�-
Snme ns pmPcm odtirts; - - —
C
as pmpmy add�a.,
spccify in Pan 4 bclow�)
undersiened certifies, under penalry o( perjury�, that ihe abo�•e and foregoing inforznation is trve and correc:t and that he or she is eligiblz to
�e the homestead standard deduction on this propeny. Each undersicned also undentands that, by claiming additional homestead deductions
��fully, he or she may be liable for back taxes and substantial financial penalties.
�u � �;�..
�v�,
��
d�•�.4 CLAIM FOR HOMESTEAD PROPERTY TAX
�� y : CREDIT/STANDARD DEDUCTION
� State Form 5473 (R2/1-90)
�' '°,• '� INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT
FORM YEAR
HC10 �O
�
certify that on the 1 st day of March , 19 �
(We) occupied as our principal place of r�sJdence t,�he, �foll wing described real property for which a Homestead
roperty Tax Credit is hereby claimed: rLT I(We) owned ❑ Are buying under contract
�Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
property or is buying it under a contract. ��* .��
If buying on contract,
CONTRACT RECORDED
where contraci is recorded
.
PROPERTY DESCRIPTION
Legal
town,
� 1990
If any portion of the residential siructure or the land not exc�eding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County � Township _� County �
ceriify the above siatemenis are true. correct and
siate
ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
VALUE
Land not exceeding 7(one) acre immediately
surrounding resideniial improvemenis (�)
Otherland (2)
Total land - line (7) plus line (2) (3)
Residential improvements Dwelling (4)
Garage (5)
Other improvements (6)
Total improvemenis - line (a) through line (6) (7)
Total value - tine (3) plus line (7) (8)
I hereby certify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
7989 Pay 1990
Lesser of 1/2 Homestead
Valuation or 52,500
�
STANDARD DEDUCTION ALLOWANCE
1990 Pay 7 991
lesser of 7/2 Homestead
Valuation or S2,000
1991 Pay 1992 79—Pay 19—
Lesser of 1/2 Homestead Lesser of 1/2 Homesiead
Valuation or �1,500 Valuation or $7,500