Homestead_Crecelius� � CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
\ � State Form 5373 (R6 / 4-03)
u� YEAR
FORM �
HC10
Prescnbed Dy Ne Departmenl of Local GovemmeN Fnance �� J��
INSTRUCTIONS: See revcrsc s�dc lor lilinq msbur.finns. J
�7 i.; s t ._ .__. � __ ,. . ..CERTIFICATION STATEMENT='. . �_ . -- .. . . ..
� IWeI QILG! / i f% D j�/l/ /) certi� tlia o7i t�e fsY��y ot March. 20_
I(We ccupied as our princiD place of residence the following described real property tor which a Homestead Property Tac Credit is hereby daimed:
/'� � Q
I(We) owned ❑ Are buying under conhact ��� ;
� Have a beneficial interest in lhe entiry Nat is liable for the property taxes on ihe property and that owns the property0r.is,�yd��tler a contract.
If buyv�g on conVad, Fee Simpla ownefs name
RecorEers olfice where conVact is recorded
cou�ry
Parcel numEer
u a�y oonia, or u,e �eva
of Ne property utilized to
Tavnship
Legal descnption
<
swcture or U�e Wnd not excaeding ne (1) acre Ihat
ice income.
Tawnship
I hereby certify the above statemenls are true, covect and complete.
Address (nomber and sfreef, cd}; stafe, ZIP code)
�DOS ��p.s� u/oo �l Dr. �r. nce.�s�-�
Rewrd number I Page
. � _. ' � .� - . `, .- ;_:ue, .
Taing tlislri(1 (Qty�jtqm� rownship)
I Is Ihe pmperty yr question:
L� Real property ❑ Alobile Homo (I.C. 67.7-7)
sunounds ihat sWUUre is used to protluce income, desuibe Ihe use antl portion
CLAIMANT
of tlaimant
Twvnship
�-- :ra ��. -� � � -_: . _
� x�`,n z�"�� � ASSESSOR-USE ONLY:�_ _ . TRl1E TAX ASSESSED VALUE =%�HOMESTEAD�' NON-RESIDENTIAC-_
,�_�,.. ' -VALUE �AT100%OF.TTV :' `VALUE-�- �e>::VALUE�.'�'
LanA not exceeding 1 (one) acre immediately � - _ � � ', .
surroundingresitlentlalimprovements. (�� . .. -.. �
Otherland (p) � - _ '
TAaI Iand Qine 7 plus line 2) (g� �
Dwelling (4) - : - . _
..1�4;r .v.:,.:�._,'.:r.> _.. . ,
Residential improvemenLS or Annually S� �___r _ _
0.ssessed Mobile / Manufactured Home Garege �5) -- .
Other improvements (6)
Tdal improvements Qine 4 through line 6) (7�
Tdal value (line 3 ples line n �g�
I hereby certify Ihe above is We, correct, and Sgnamre orASSeswr Date signed
complete.
Verifying actwn - SignaWre of AuOitor Date signed
.,�i`'`' - � - `� -�ST/WDAR�.DEDUCTIONALLOWANCE�_' � ' � -
20_Pay20_
Lesser o� 1!2 Homes:ead �
vauamn or 535.000 S
SgnaWreofAUdilw ' Datesignetl
�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
1509
ll�iEf00.N`!MIR:/�1
RLW:ILI WRN.ti. IA
Indi�iJuaL and marriN roupk� arc limitcd to orc hnmcaeaJ yaiMartl JcJuctiort A> ihc rtteipt ol' Utis Jcduninn birrnrcs
murc beneficial, thrrc is marc incrntire rfun ner (ar homorcad fnuJ. Home.rc:rl fmud cauxs hr,her �aa bills fm all: therefore.
HEA Gii-?(HW requires u�pa�ers w�ho receive Ihe hanrst.aJ smnda�J JcAuction e cerily that thcy ue elieiMe lo mcti�c �he
benefit anJ to pnn'idr aJditiunal identiiyin_ in(urm�oon nemsary to allw' counp' gm'rmmeni ro W.ner mwiror homeste;xl
filinf�. This in(mrtutinn r�ill Ir Aery mnLJenlial anA nn nnh' M arres�eA M' aulMrvN cnumy o(Ticiul.a. l3e IkTaMrenl nf
Local Gm<nvncm FireMC will u.c this in(onnation �u crcatc �wls �hat �rill h:ip camcy uffi�alz climimnc humc�icml fiauJ.
. � � � � �
Taipacer Name Prnpertc Address
Crecelius, Mary A
Mary A Crecelius
2005 Glenwood Dr
PRINCETON IN 47670-1040
�i�u��ui����n�u����nini����nu�u����n��nu���u��n�
?00> Glrnw�c�d UR
Princeton IN 37670
State Parcel Number Leaal Description
1( 26-11-12-103-002.372-028 019-02372-00 TOWER HGTS 279
1' 1
Owner i First Rliddle La9
� ecefius
ng AEErcss �nrmticr mid �vm, city, stere. end ZIP�cadc) � - - ��'�Su�c ns propm� sidrss — - - . _ .-. - -
D v e� co 0 o d 7�, __ �i� n e�a n `r�7G o
Social Securily Number (last 5 diciLS) Uriver's License/$late ID Nmnber (Im� 5 digits) � Oihr� (pleice specify in Patt 4 below)
�
Spouu Firs[ Middlc last
Mailing Address (I�umber and stiee4 cil}�, slale, and LIP cuJe) � S:une as pmprny addrei.;
Social Sauriry Number (lazt 5 dieits) Dm�crs License/State ID Number (la;t 5 diei[s) Oficr (plevice specifi• in Part+ hyow�)
sos
. � � �
Each undersigned certifies, under penalry of �rjury•. [hat the above xnd Foregoing infortnation is true and cortect and that he or she is eligible to
receive the homestead standard deduction on this propeny. Each undersiened al>o unders�ands that, by claimin¢ additional homestead deductions
unlau-fully, he or she may be liable for back taxes and substantial financial penalties.
Owna 1 $i�maNrc Unte 7'elephonc
/� - .5 a�o
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S�rouxSi m: � iclephonc
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11 1 �' 1
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