Homestead_Smith (44)CLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD / SUPPLEMENTAL DEDUCTION
- State Fwm 5473 (R73 / 12-09)
` � Presaibed by the Department of Local Gwemment Finance
Fo� � I �
HC10
INSTRUCTfONS:Seereversesfde%rfilinginshuclions. APR 5 Z��2
. .
1(We) `"� . ��.J certiry that I(we) occupied as my (our) p�d�
place of r e or a are) buying the fWlowing described real property for which a Homesiead Property Tax Siandard D��s��r��y�i ime�f.�T R
9UDI
�er co ct on the date this appliption is filed, (date o(filing). I(We):
Own ❑ Am (are) buying under recorded conVect
Am (are) enlitled to occupy as a tenanbstockholder oT a cooperaUve housing corporation
❑ Have e benefidal interest in ihe Wst or the right to occupy ihe property under ihe tertns ot a qualified personal residence Wst .
❑ Am (are) the shareholder, partner or mem6er oi the enlity that owns the property.
•• • e
Nameotd � nt name)
Sodal ry of m(gst _d+9�) of daimanhcense /� ���lon / ON� �� Issuing Slate
Sodal Securiry numEer
/
.,- . .-. .
If buying on concraU, Fee Sirnpla owners name
Recorders of6ce where contreti is recorded Record nurtibei Pape
..e. . � . �
counry 7a.mship T (ryy: row,,. ro,msn;a)
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Pa�cel number � �P�n Is Ne in question:
-�-�(� Real poperty � AnnuaOY essess�W moWe home (IC 6-7.1-7)
If arry portion of the fcvdendal sWCtura a 1he IafM not exceeding one (1) acre Uu� immetliately �� cWre is used m produce income, desaibe the use arvl portion
w me o�cem �w�a ��oa,ce mc�e. ,
��lo -�o?-O% /a�- DQ/. /.3�-6a��
- •�• e e : • �
Caunty Taw�sship Counry TamshiP
I hereby certify ihe above statements are We, correct and complete. SignaNre of tla t
nea,���,e„e��.�'r� S�'�r�-`-�:� � ��Cz��
.• .
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Land not ezceeding 1(orre) acre immedlately .� i s ,�'"4.. -;:'� t ��; `�'
surroundi resldential im mvements. ��) �'��??' ��'`'�`' .._ ^'� '~-r''°i°�
s_ }` •G:�,Yt -G
Other land (2) �,� ��`: �.�=
rora� �and (�irre 1 plus �irre 2) � (3)
Dwellin9 �4) at.�'"�r�.*.,•�c���',r�--�"r
Resideirtial improvemenu or Annuaiy � . .
Asseased bloblle 1 ManufacL�red Home Ga�9e �5� t.�� ��y� ��� �¢��,� i�,-�,'=
*' �;s'� �.{: ' � - - '
Otherimprovements (6) s � �;-
Total improvemeMs tline 1 Nrough line 6) (7)
rmai �aW. �r,ne � pr/s mre n (s)
I hereby certify the above is We, wrtect, �9"a� of Assessor Date signed (monm. tlay, yea�
and complete.
Veilying action - SS�Nre of MWitor Date signed (rtqnfh. daY. Y��
� • • � � � e •
20 _ pay 20 Lesser of 60% of the essessed value oi the homestead or $45,000
Nolwilhstanding any oNerpravis,on. Ne sum o/Me deductims provkled in /C 6/.7-/2 ro e rmW7e harre Mat is $
rat essessed es iea� a�aem w ro e menNaaured �ame mer is na essessed as reer v�veM rnay mr exceee �
one-haM(f21 dNe essessed value o7fhe rt�oWe hwne or manidaGUred home.
SigtaWre ofluditor Date signed (month. daY. Yea�
i . '
(D�A\AS.LLESDISCLOSUREFORdi SDFID SDOID 728213 Page2
D.PREPARGR � �
Kimberly A. Lewis Ofice Manager
R'ryart� of Ihe Scles Obdnsvre Form 7iJe
( 226 W. Broatlway Broatlway Title, Inc.
AdJrn> (XumLei anASVre�J Compon.y
Princeton, IN a7670.
Steven R. Blume
Srller 1- 4'ame us oppr rs w mm�ey�mae Jaument
438 Spruce S�.
AAdress (NunM1er ond Suret)
Princeton, IN 47670.
�' Lade
Katherine J. (Vickers) Blume
Selfer 2- Nemr asnppen^ om m�viwnie davmen�
438 Spruce Sl.
ACErm (NUmber ond5-vee[)
Princeton, IN 47674
liry. Smtc, nnn ]IP CaJe
Under penalties of perjan•, 1 hereby certi(y that this Sales Disclosure, to [he best of my knowledge and belie(, is true, mrrect
an omplete as qui by law, and is prepared in accordance with IC 6-11-S.S, "Real Pro erty Sales Disclosure Act".
� �
y � . ��ur..k L� , ' � � .w""�
Si,qnumreof5dler +Si/gnao�re Seller ' p �l
��rvr.t �E. 3%u�e ��'�-if K2�/iif�ac� .� (����.wC- �.Z�7��/
�Rrey L Smith J
Buperi�n' .,oppearsanrnnvewnredo�vmen:
ZT� Taylor Ave.
AJdress (X vmber ond Sverq
Princeton, IN a7670.
Ciry�.Smte. acC ZIPCw:e
NS- 16EN,TIFYALL ITEMS THATAPPLY
Terti F.
�y, ,np¢orsamm�vnnncedanrmmt
2704 TaylorAVe.
Addr¢c (Num6er and Strer�J
Princeton, IN 47674
TIIE 5.1LES DISCLOSURE FOR51 MAY BE USED TO APPLY FOR CERTAIN DEDURIOYS FOR THIS PROPERTV. IDENfIF1' TLL OF TNOSE THAT APPL\'.
Q � I. Will chis property be the buyer's primary �
residence? Provide wmplete address of primary
residence, induding county:
438 SPRUCE ST.
Address (NUm6er ond So-mo)
Prince�on, IN 47670 GIBSON
Cin, Sm:e ZIPCaCe CounN
❑ � 2. Does the buyer have a homestead in Indiana to be
vacaced for this residence? If yes, provide
:rompleie address of residence being vacated,
induding rounty:
Addrm (A'vm6rr andSvtet/
Ciry, Sm[e ZIP eode Counrv
❑ 3. Homestead
ng/Cooling System
Lf C�f S. Wind Power Device
� Q 6. Hydraelectric Po�ver Device
❑ Q 7. Geothermal Fnergy Heating/Cooling Device
� Q 8. Is this properry a residential rental properq�?
❑ Q 9. bVould you like to receive tax statements for this
oroperty via e-mail? (Provide conma informotion
below. Plense see instructions%r mare in(ormation.
Not available in oll rounties.)
�G-/a-��-/ar- aQ�. /.3� aa�
I'dmaryP�Verryorvnercar.mofnvme E�mail
Under penalties of perjury, I hereby certiFy [hat this Sales Disclosure, [o the best of my knoH•ledge and belie(, is true, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales Disdosure Act". (Note:
Spouse informetion, Social Securi nd Driver's License/Other numbers are not necessary ilno Homestead Deductlon is
being file /)�% ( �p
A� �!/�l'vt, ��vc�- � 1t � �c r, � V` M 1-W�
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SocialSecuriry