Homestead_Davis (15)•
Gibson County Auditor
101 N Main
PRINCETON IN 47670
3774
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P1.15LFFA W0.4 �3-IA
InJi�'iJual� and m�rrieJ couplr.: arc limiud w ore homcueaJ �randaN i4dunion. As �he receipt of Ni� dedunion bectmces �
murc benefival, therc is more fncrntne than e�er fer homesteaJ fraud Homra�eaJ fauJ causes higher tan bflls fw all: Nercrore.
HEA 1333-?IX!9 rrquim uxparen who reccirc Ihe hwnesicad standarJ JeJuainn to veriir Ifui thc�' are eliciNc m retei.c the
brn<fit anJ ro pnr�idr :xkiitio�ul idrmiirinp inWm�a�wn ncY�e.>ary to allw� county garmmem �o bener moniror hunxsm�J
�ilin�.�+. lliis fnlomu�inn will be Aryw rnntidcminl and r.m nnly M: accex.zA M1�' amMriznl rnunly nllicinl.�. Thr IApanmcm n(
I.ocal Gm'emmcm Finmrce ��ill u.c �his information w cream twls iMt aill hclp rpmrv ofheials dimiwrc Mmms�nJ fiaud.
. , , , , , .
Trxoacer Name Prooem� Address
Davis, Robert M/ Laura L
Robert M/ Laura L Davis
1017 S Race
PrincetonlN 47670-2728
I�I��II���I�II��I���III�����I�II���I��I�II��I����III���II�I��I
1017 S Race
fkincemn I\ a7670
State Parcel Number Leeal Description
�( 26-12-18-200-000.416-028 019-ooa15-ao SS ADD 223
�
' Owner I First MidNc Lul
%ii a � � a v/
g Address (number and smze, city. s�ate. and ZIP codc) �- - - -- - - �� Snme as praperry oddicss �— ��- ��
o S_ r� ce__�.� �/v 67a
$ocul $
Spou;e Firs[ Middlc La.t
r Le ✓�s
Mailinc Address (Number and stree4 aiiy, sta�e, and ZIP cuJe) � S;+me as pmpeny add�as
,. . ,
Each undersitmed certifies, under penxlty of perjury�, that the above and foregoing information is we and coirect and that he or she is elieible to
receive the homestead standard deduction on this property. Each undersi¢ned al;o unders�ands that, by claiming additional homestead deductions
unlawfully, he or she may be liable for back taxes and substantial financial penalties.
O�.na I SiFne4uc (htc 7'cicphonc
,5- � (
.� � .� �
d%^n� CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
�j�i: CREDITISTANDARD DEDUCTION HCio �
�� Sta1e Form 5473 (R2 / 5-92)
���•i. � � ���� �
INSTRUCTIONS: See reverse side 7or tiling instiuctions. •
CERTIFICATION STATEMENT
����� f�, f
��We) CriJrN� cenify that on the 15t day of March. 19 9S
��) occupied as our principal place of residence the following described real property for which a Homestead Prope Cre i�her�p� I�d:
�1(We) owned ❑ Are buying under coniract AUDITOR 0�
Have a beneficial interest in the entity ihat is liable br Ihe properry taxes on the propeny and that owns ihe property or is buying under a contraci.
- CONTRACTRECORDED .
II 6uying on contratt. Fee Simple owner's name
Recortler's oHice where convact is recorded Record number Page
PROPERTV
Coun;y
Parcel number � Legal
(city mwn.:ownship)
``.�.j 1" 1VCJ � 1 lQ I ��SXJ 1�L,OCC.� Q' ��
If any portion ot tne residential stmcture or 1he land not e.ceetling one 1 t 1 acre that immetliately surmuntls that simcture is used to produce income. tlescribe the use and ponion
of the oropetly utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES •
Coumy Township County I Township
�
��eby cenify the above statemems are true. correct and complete. Sgnayt • ol claim m
X Y���G�-��..,� �
Atltlress (numbe� and� sfreef. ciry. slare LP [ode)
� ,l_� `F�,
ASSESSOR USE ONIV TRUE TAX ASSESSED HOMESTEAD NON•RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately I(' I I I
surrounding residential improvemenis.
Other land (p)
Total land (line i pWS line 2� I(3) ( (
Dwelling I (4) I
Residential improvements
Garage �5)
Other improvements �6� � I
Total impmvements (line a through line � I(7) I I I
Total value (line 3 pf�s line � (g) I I
I hereby certify the above is true. correcL and I Signawre oi Assessor I Date sfgned
complete.
�yirg action - Signa;ure ot Audiror Da;e signetl
19_Pay19_
Lesser of 7l2 Homesteatl
Valua�ion or 52.000