Homestead_Davis (12)� SfATEFO&NS1JM�/SIO� �� T14ASURFAFOANI$IA
APPRO.'FDBI'Sf�TERMRDOfKLOUYiS,M/I YRESLR19mBYT1�DEPARIME�TOi1[Y'AI.fA\'EA�MEYI'f1NAV(F.1C41.1-Sldl
Gibson CounryAuditor � � • � � � � � � �
101 N. Main Street �ndividuals and matried wuples are limi[ed W one homatad siandard deduction. hs the receipt af �his deduction bemmes
P�f1C2iOf1, IN 47670 `, more beneficial, ihcm is morc incentive �Fw� n�er (or twmcstcad Gaud. Homatcad faud wuus higha uz bills for all; thcrefort,
�� HEA 1344-?009 requves racpayers wiro receice the tiomcstcad standard deduction to ��crify that they art cligiblc ro recen•c thc
brnefit ad to prmidc additimtal idrnu(�ing in(ormaUOn nttCiSa.-v b allOw COWty EOVCmmCni b bcacr monitor h¢nestead
- filings. Tnis infofmation aill bc kcpt wnfiden[ial and can onty bc accessed by authoriud county affi<ials. Thc Di.parm�rnt of
I.ocal Grn'ermnrnt Finznce will uu this informazion ro create tools that will help crounrv officials eliminate Iwmes[ead fnud.
�85
William / Carol J Davis Il
323 E State
Princeton IN 47670-1833
TaxoaverName LocationAddress
Davis, William /1 Carol J
323 E State
PnncetonlN 47670
c
Illlul�lll��lll �II�' �II II� II �Ill�l�llll�ull�ll�llll�l�l�
'��I��"II����"'�'I��'I'lll����'�'�I��"II�'�'�'��'�I'��'�I��'�' State Parcel Number Leqal Description
2612-07-203-003.023-02�7 Se 7-2-t0.o5 nc
_ .. . �^---.``A' � 1��TT_ PLAN38PT
L
APR 2 8 2011
OLD
c�.m�
' This form MUST be retu��l,bou�b��jTPAuditor's o�ce. e
Please do NOT send this form back with your tax payment to the county treasurer.
�
strec�, ciry', staie, and ZIP code)
� I 1�v � � � �
� Same as properry address -
5 digia) OtLei (pleau specify in Part 4 below)
�Sme „
Middlt
_ B-e-r'�'i /�-� U , �
ciry;statc.and7.IF�ccde) . . . .. .^'��-}�an:r
,��.
�
License/5tau ID Number (12t� 5 digiu)
� �
m
specify in Pari 4 below)
undersigned certifies, under penalty of perjury, [hat the above and foregoing information is We and correct and that he or she is eligible.to
+e the homestead standard deduction on this property. Each mdersigned also undecstands iha[, by claiming addinonal homestead deducrions
�fully, he or she may be liable for back taxes and substantial fmancial penalties.
1 Signanne -
���n � ��
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e °
:�'�
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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
Siate Fortn 5473 (R2 / S92) .
INSTRUCTIONS: See reverse side !or �ling instructions.
FORM
HC10
YEAR
� CERTIFICATION STATEMENT
I(VJe) /` / r �. / � certify that on the 1st day of M rch, 19_
I(VJe) occupied as our principal place of residence the following described real properry for which a Homestead Property T Cr i b laimed:
❑ I(We) owned ❑ Are buying under contract ��{, �, .
❑ Have a beneficial interest in the enfiry ihat is liable for the property taxes on the property and that owns the pro� l��ying und a contract.
; 2�U�
CONTRACTRECORDED �
If buying on contract, Fee Simple ownefs name -
�r
. „� �O�
Recoraets omce where contract is recordeA • auriiDeJiN �'' Page
rn �..
l, ..�r_�
�� �
PROPERTY DESCRIPTION �
Counry `� TownshiP �� � Taxing district town,.tmmshi
� ii�:�
Parcel n ber Legal deuription
� �"- 03023 0
If any poNon of the residemial sirucWre or ihe lantl not exceeding one (1) acre that immediately surtounds thai swcW re is used to produce income, descn�e Ne use aM ponion of
ihe Property utilized to produce ir�come.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Cauny Tovmship Counry Township
Signat re of claimant
, ereby certify the above statements are true, correct and wmplete. �
Address (num6er anU slreet, dry, state, ZIP cotle)
3 ;�, 3 � ( 70
� ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
L.and not exceeding 1(one) acreimmediately (�) .
surrounding residential improvemenis.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4) �
Residential improvemenis
Garage (5)
Other improvements (6)
Total improvements (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify [he above is true, correCt, and Signature of Assesor Date signed
wmplete.
Verilying action - Signature of Auditor Date signeC
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead e�
Valuation or 52,000
Signature of AWitor Date signetl