HomeMy WebLinkAboutHomestead_Davidson (5)CLAIM FOR HOMESTEAD PROPERTf TAX
CREDIT/STANDARD DEDUCTION
Stete Fwm 5473 (R6 / 4-03)
PresuiDed by Ne Department af Local Govemmeni Finance
INSTRUCTIONS: See revarse side /or filrng instn�cfions.
FORM �� YEAR
HC10 �
1 W 0. � �J �
,� ��,��� JAN 1 9 cuu� —
I(We) �"__��� � certify Ihat on the 7st day of March, 20
I(We) occupied as our principal place of residence Ihe following described real property for which a Homestead PropeAy Tac Cre51j� j�-hereby daimed:
�6� �GS/.V'6'
� I(We) owned ❑ Are buying under contract TY DIiO�
' Have a benefidal interest in the entity that is liable (or the property taxes on the property and that owns fheQfB���rR�iurng under a wnVaG.
I( buying on contrad, Fee Simple owners name
Remrders olfice where conUaq is remrded
Counry
Counly
7avnship
Legal
—U.7Ub7'GCJ i uv�rt
n ot Ihe residentlal sWCture w the Wnd not exceeding me p)
rry u yap� irxome.
/ �' ,�
I hereby certify the above statements are We, coneIX and complete.
(numbu aiM street city, sfafe,
Rewrd number � Page
Tmcing tlislrict (ciry, town,
Is the Oroyerty in question:
❑ Real property ❑ Mobile Homo (/.C. 67.7-7)
sunounds lhat swCUre is used to praduce income, desfiibe Ue uu and portbn
County
`'�a:a�ns -i�rw �'�'4'��' .-�° .. s_s . . _ . . . _�a
� .,�^ SASSESSOR'USE ONLY �.�°-���'�',''��-_' �u VALUE �r" AT.E 0% OFTTV� ��J+�,H,�VALl1E�D`�: NON'�'VALUE�i,'�'���+� `-�,
Fh'��i�'r�RY':"��Cc-6.nl�i'W^;� _ eS �� -�'��. 3 Yf�Y .-er c„s; vc�.�?'�.o- ,..� C�<t.-�".i'�.E..�....�..er�`a�t�
Land not exceeding 7(one) acre immediately �.��-v.�¢ '4' .�5p�'
sunounding residenGal improvements. (� � � �fii: '' `? Y'`e54? ` '�
� �!. . � �ts��_Y.
Oiher land (Z) }���"�N5 ��T���`��'�"F
:�;-'���.:,'�`�e�
Tqal land (line 1 plus line 2) (3)
Dwelling (4) �,.yfq'�%� �.�,d�!�����
�Residential improvemenLS or Mnualty "�`�'"'d`�` �A"'�a ``�
Assessed Mobila / Manufaclured Home Gare e �-�� �`f'�-s'
9 (5) ������.�c . �,~����
Other improvemenis (6) tt�.�,���� •.q
x^._%s-L-� V:
TUaI improvemenLS (line 4 fhrough line 6) (7�
7Aal vatue Qine 3 plis line n �g�
I hereby certi(y �he abOVe IS We, coneG, and Signature ofASSessor Date signed � �
complele.
Verifying actbn - Signature oflwditor Date signetl
20_Pay20_
Lesser of 1/2 Homestead
vawauwi w E35.000
3
Sgnature oflwdita , /\ /� � � / � Dale
�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
1600
SIiRiOAM!!'Mlti/�1
.\�iRIT'Fl1Bl"ti�IEM\p0l1FM.�� T.'vw
1RfASURE0.%10.411A
IndiriJuals and ma;riN coupl� are limited m nnc homvcaJ �and:iN Jcdunion. As �hr �ttripi of Ihi> dMunan Mcanes
morc bcneficial, therc is more ircrnmr dun e�cr (or honmtead fqud Ilomr.�eaJ fraud causes h�her ta� bills for all: therc(ae.
HEA Lili-'_fIM requim uxprm v:ho reaci.c ihc hwnes�caJ smndaN JNunion m.cril'y �fm thcy am cliciMc io maenc �hc
benefit aN ro p�m�ide a�Ylitional iJentiiri� infurmatwn nece>'vn� �o allw� counn' gm'rmmeni ro betmr monitw homcsrcaJ
filin��.'Ihix iNO�maiion will 6e Aryw mn6dential anA �n only Fe avrev.nl hp amhnrivnt rnunry� n(Lciulz. Thc Ikrywnnxni nf
1_ceal Guvertmmm PimM'< ��ill uw this infomwtion m crcam cwls ihn will h:ln �ounn' uflkials eliminnm M>mateaJ fiaud.
Glenn Davidson
209 N 9ih St
PRINCETON IN 47670-1119
I�I��11���1�11��1���111������11���11,��111�1��11���1�1���1�1�1
er 1
a lenn
1ig AGAress (number m�ti sveet. cirv.
.4ddress (Number and stree4 ��}', s�a�e, xnd LIP cale)
Sccuriry Numbcr (lu� 5 digits)
mraai<
u. pruperry' widjcs�—
fU Samc as pmpcny addrc:;
LdL
undersiened certifies, undzr penalty o( perjury, that the abo��e and (uregoing infortnation is we and coirect and that he or she is elieible to
:e the homeslead standard deduction on this property. Fach undersiened al>o understands that, by claiming additional homestead deductions
+fully, he or she may be liable for back taxes and substantial financial penalties.
� I Simuauc Ih�c TcicOhurc
s�«
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