Homestead_Coomer (23)9
M
Gibson County Auditor
101 N Main
PRINCETON IN 47670
3093
IAFAS11AGfU0.431n
InJiciduaL. anJ in�:riN couplo arc IimitN m onc Mmc.aeaJ .aandaN JNunion. As Nc recatip� ol'this dcduninn brcome�
murt beneficial, therc i> morr incrnmr than rcer (or homdteal G:md Iiomnxad GauJ causes higher tax bills (or all; �hrrefore.
HEA 13�1-i-?INl9 requim uxpoycrs who rrcive ihe IwmesicaJ smndard JNuction tn .crify ihai ihey arc eligiMc io mcci�c thc
brnePo an1 ro pnn'id< aiklnional identiirin_ infurmatwn nne.'vn to allw' aewnp� gucemmrnl ro b:trer munimr humesmaJ
filin��. This in(nmu�inn will M Aryv contidemial anA c�n nnly h: acctti -J hr autMriid rnunty nffcialz. Thr Ikptnmrnl o(
Lucal Gm�cmm<m Fi`uirce will u.e chis intonnafion W crca[c 0.ois ihat will h:Ip couniv ufficials dimin,vc humenead t}aud.
. � � � � �
T•rspa��er Neme Prnpert�� Address
Coomer, Whitney Michelle/Adam
Jarred Tro � K/'1n �
62ft S Seminary
Whitney M Coomer
628 S Seminary
PRINCETON IN 47670-2436
I�I��II���I�II��I���III�����I�I�I��I��II��II����I�II��I����III
1'rinceton I\ 47670
State Parcel NumAer Leeal Description
jt 26-12-07-403-000.433-028 079-OOa33-oo SUMMERS ADD 12
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a.�«i���h i�- i✓ e j r�rsi �✓l r e ri� c�� ntiaai� c o o n g2 �i
i-� � f� 1�'� �/� 2�- t� �' i^ o C'. N/'1') � n/�
•;ig:.d�:.y(r.umt:.r-w.d�strcc:::i:j.sa:c:xdZ:^cadc)— — O�—" _—'rviSx�cn,prcy::tyod�'.�rs---- — '—
��, 8 S. S e rn�;�� �5 st ��i
�h � n� � e t� i�� 2,rr ,� 7� ? o
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Firs[ Middle Last
Mailine AUdrexs (Numbrr end slrcr4 ciiy, sule, nnd "LIP cuJe) � Same u pmpeny:ddrts
Social Sccuriry Number (lazt 5 digirs) Drivers Licc2sclStatc ID Nirtnber (la,t 5 digi�s) O[M1er (Plcnsc s7KCify in Part? below�)
smz
� . . �
Each undersignzd certifies, under penalry of perjury, tha[ the above and furegoing infortnation is we and correct and that he or she is eli�ible to
receive �he homestead siandard deduction on this propeAy. Each undersigned al>o understands that, by claiming additional homestead deductions
unlawfully, he or she may be liable for back taxes and substantial financial penalties.
Ow�ner 1 Si�hse Us4- 'I'elephonc � � / �
� � .4�c,t-�'�e-�1i1 �i� / CJ ( � � � %-
S�au>c Signa[ure / I Uatc Tdcphonc �
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�_�P/'�:�"„n . d .z,
,'�-f�n�/L h i , �nii �lii�a C�,
� ,P� 6 .✓I � c�! /LQ in' ) A .%1�"/ � �7 /
lt
�a n�r� .
a�-�'°, CLAIM FOR HOMESTEAD PROPERTY TAX
i;��: CREDIT/STANDARD DEDUCTION
,�.` � State Form 5473 (F2 / 5-92)
�s�e
INSTRUCTIONS: See ieve�s sr /orliling inst t nnn,
�i-OH �xY1 K/ �/ U
. � , . • ' - •. . � • ERTIFICATI
' FORM YEAR
HC10
� �vve1 _�-_T�- i w . /ii . � .
) occupied as our principal place of residence the following described eal property foi whi a s
/
�(We) owned ❑ Are buyinq under coniract .
❑ Have a beneficial interest in the entiry ihat is liable for the property taxes on ihe proper� '�'�a•'�wn� " �rty or is buying under'a�co`ntracf? � I
- . � CONTRACT R� /� / � . -
If buying on contract, Fee Simple owner's name
necomer s omce wnere convact is retomea
Counry / �
Parcel mber Legal tlescription
�/�-- DUSG33�-0 0
tl any portion ot the residen6al stmcture or ihe land not exceeding one (7) aae
ot the property utilized to produce income.
. / .
� Recortl num6er Page
r
DESCRIPTION -� �
Tazing district (pty, rown wnship) � ,� �
,� me�t � C� / �--
surmurMs that strucmre is used to produce income. tlescdbe the use and portion
- . �
ASSESSOR USE ONLY �� TflUE TAX ASSESSED HOMESTEAD � NON-RESIDENTIAL. .
VALUE VALUE .VALUE � VAWE � -
Land not exceeding 7(one) acre immediatety �
surrounding residential improvements. (�)
Otherland �p)
Z
Total land (line 7 plus line Z� (3�
Dwelling (4) _ � - �
Residential improvemenis _ _ __ _ _
Garage (5) � �
Other improvements (6) ��
Total improvements (line 4 th�ough line � (7) �
Total value (line 3 p�s line 7� (g)
ereby CeRi�y Ihe above i5 Irue, GorreCl, and Signature ot Assessor Date signed
mplete.
Veritying action - Signature of Auditor . Date signed
�
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