Homestead_Ernste�%"� E CLAIM FOR HOMESTEAD PROPERTY TAX
. CREDIT/STA�DARD DEDUCTION
s' ,
., f�y ,f,� Sta�e Porm 5473 (R2/5-92)
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INSTRUCTIONS: See reverse side-for liling inshuctions. �� g/,db
� . . . ._ ._ . . .. �- --'—'—'—'—'—"--'--'--"—
' ' FORM YEAR
. HC10
I(We) certify th on e st� . 19_
�) occupied as our principal p of residence ihe fol wi g de>cribed real property tor which a Homestead Prop a di reby daimed:
f1�Y "�9 19�1
V I(We) owned _❑ Are buying under contrect , . -
❑ Have a beneticial interesi in the entity that is liable tor the property taxes on the property and that owns th roperty or �s uy under n ct.
�:.:: ���
r+.�cpn� „OUr ry rUDITOR
� � � - � CONTRACT RECORDED _ � . • '�
If buying on contraa, Fee Simple owner's name � . . . . . . � . ' '
Recorder's oNice where contract is recortled Record number Page
Counry
"� PROPERTY
Township - �
fOwn,
�l / _D/( /� WI � M 'vv' ' /_r 1 M . . I�� Y _� l l� / �
II any portion of the residential structure or the land not eacee ng one (7 � aue that immediatety surrounds ihat siructure is used ro pr uce income, describe Ihe use antl portion
ot the pmperty utilized ro praduce income.
0
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD� NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding t(one) acre immedia[ely -
surrounding residential improvements. (�) -
Otherland (p)
Total land Qine 1 plus line 2�- (3)
� Dwelling (4) �
Residential improvements
Garage (5) '
Other improvements (6)
Total improvements (line 4 through lina � (7)
7otal value (line 3 pbs line � (g)
I hereby tertify �he above i5 Uue, torreCi, and Signa:ure ot Assessor Dare signed
compleie.
V�entyirg action - Sgnature ot Autli;or Date signed
�
79_Pay79_
Lesser of 7l2 Homestead
Valuation or 52,000
DEDUCTION ALLOWANCE
5
�=as s
�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
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s�re �.m.i ��witii...��
rw.�mtu rua� :su
InJiciJuak aod ma; riN rouplc are Iimi�N io ore hmmc.acad �ranJaN Jeductinn. As �he �eceipt ot �his dedunfnn bccomes
morc beneficial, thrre is morc incenme dun ner (cr home>rcad fraud Ilame�ea�i fiaud ca� higher tu 6ills fa all; thertfae.
HEA I i�4i-?IX!9 requim u�papers who nccive Ihe hnnene�d standa�d JeAuc�ion m.erify rtul �hey sre <IigiNe lo recei�e �Fe
benefit aN ro pnn�ide adliGo�ul iJemfiyfng in(om�a�iun nece.sary to allow' counn� garmmeni ro N�¢r monirm homes�e:�i
nlim� .'Iliis iniormation xill br AcryN tonlidential and r�n only h• azmuJ bp autMmN rnunry� n(Ticials.'fhe Depannum of
Loeal Gm'emmrn� PinaMe will me this information N arca:c twls �ha� �rill h:lp aounw uf(xiaL. climinarc hom<>tcad irauJ.
.•, ,, ,
T•rzp•rcer Name Pronert�� Address
King, Phyllis I
ziosna��,>sr
PrinciKOn IN 47670
3315
Phyllis King I I
210 S Adams ST State Parcel Number Leeal Description
PrincetonlN 47670-2208
I I II I II I III I I I III I I II II II I x26-�2'08-301-001.112-028 019-01112-00 LYNCH 2ND 122PTI723PT
i n iii i i� in inu i u i iu n ini ni�i i
Address (number end �o-eet, city, state, end ZIP cadc)
nima¢�
i�NE �/�//VG� �2N5%
_ _. - _ . � Samc os PTaP�M �a� — _
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Addrtss (Nwnbcr and stree4 �i)', siatc, and'LIP cak)
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ID Niunbcr (lazt 5 digits) � Other (plcltic
sify in Part 3 below)
E�NS f
�Samc as propeny adJm�
:cify in Pan+bclow)
undersiened certifies, under penalty of pequry•. [hat the abovt and foregoing infortnation is we and colrect and that he or she is elieible to
re the homesiead standard deductionon this property. Hach undersigned al;o unders�ands that, by claiming additional homestead deductions
.�fully, he or she may be 1ia61e for back taxes and substantial financial penalties.
1 ignapac ,. 1 Datc Tcicphonc
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