Homestead_Fark, - _
aa �°, CLAIM FOR HOMESTEAD PROPERTY TAX
i•�'� CREDITISTANDARD DEDUCTION
„�� ,,�� Slaie Form 5<73 (R2 / 5-92)
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INSTRUCTIONS: See reverse side lar liling instiuctions.
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9t� ��i / C�LY-(_.I/l.tA_ V � certify that on the 1 si day of March. 79�
pied as our principal ce of reside e the following described real property for which a Homestead Property Tax Credit is hereby daimed
�(We) owned ❑ Are buying under contraci , . .
Have a beneficial interest in the entity thai is liable for the property taxes on the property and ihat owns the property or is buying under a coniract.
- - . CONTRACT RECORDED . � �
If buying on contract, Fee Simple owner's name � .
Recortlers oHice where contren is recordetl Record number Pa9e
PROPERTV DESCRIPTION
Counry . Township � Taxing district �ry, fown, mwnship) �
Parcel numher Legal descrqNi '
a q- 01 "1 I 8-o � �,t� `/2
If any portion of the residential svuaure or the larid not ezceetling one (1) aue that immediatey surrounds thai strucmre is used to protluce income, deuribe [he use and ponion
of the propeny milized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUN'fIES
Count� I Township
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certify the above statements are true, correct and complete.
A es num6erandstree�. ciry, s�te, ZlPCoq§j A�
ASSESSOR USE ONLY �
Land not exceeding t(one) acre immediately
surrounding residential improvements.
Otherland
Total land (line 1 plus line �
Dwelling
Residential improvements
Garage
Other improvements
Total improvemenis (line 4 through line �
Total value (line 3 p�s line 7�
I hereby certify the above is true, correct, and
complete.
19_Pay19_
Lesser of 7/2 Homestead
Valuation or $2.000
TRUE TAX
VALUE
(�)
(z)
(3)
(4)
(5)
(6)
(�)
(8)
of Assessor
ot
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ASSESSED HOMESTEAD
VALUE. �VALUE
STANDARD DEDUCTION
$
Signature oi AuOitor
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NON-RESIDENTIAL
VALUE
Date signed
Date signed
Gibson County Auditor
101 N Main
PRINCETON IN 47670
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rnr.vniuxroxwz�n
hWividuaL. and nurriN coupl� are limited �o onc hm�rcucaJ wandaN �L-Junwn. As ihe �eceip� ol ihis dcdunion brconre�
mure bcncficial, there is morc incrntire rhan ecer (or hon�rcad frauJ. I lom�tc�d fmud cauxs hi�her ta� bills (or nll: thercfore.
HEA 1333-?009 «quim uxpacen w�ho receive Ihc hanestmJ 5�andud �kituttion to veritv �lue ehey am CliciNe to mcene tht
benefit ani ro pnxidr aJJitiunal idenuivinc infurmarun Mcevarr ro allw' counn� eo:emmeni ro bener munitur homesreaJ
filin�,�. This infnrmminn will br Aryu mnliceNial anA cnn nnly h attn�cA M1r autMri�tti oounq� n0iciah. Thc Uepanmem nf
1 ocal Guv<mmcm Finmm< �vill mc this inIO�macion W arcam �wls iha� �rill h:ln awntt o(ficial> climi�lc humc.tcad (nud.
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APR 1 2 2010
2645 ,/
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Timothy / Jean Fark GI9SOU C� 7Y AUDITOR
318 E Spruce
PrincetonlN 47670-1750
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,:nd � -ee::i:�: sau: c�d ZIP coCz)—
Sccurity Numbcr (last 5
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Address (Number and riree4 cii}', siate, and'GlP c�nk)
Security Numbcr (laa 5 digi�s)
Taapaver Namr Prapertc AJdre�s
Fark, Timothy / Jean
318 G Sprucc
Princemn I� 47670
State Parcel Number Leeal Description
2612-07-201-001.718-028 07s-o171s-ooOLD Pv+N 119 PT
V
85 PT(!!'T' 9�aIC:.i.
Othcr (plcasc spttify in Part 4 bclox�)
�'c�ItiZ
u pmpeny address
O�hcr (picssc spcciN in Part 4 bclow)
mdersigned cenifies, under penalty of pequq•, that the abo�•e and foregoing infortnation is we anJ coirzct and that he or she is elieible to
e the homesiead standard deduction on this propeny. Each undersiened al;o undemands �hat, by claiming additional homestead deductions
fully, he or she may be liable for back taxes and substannal financial penalties.
I Sicnat�ve f}etc 1'dcphonc
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