Homestead_Pritchett �" "m"a CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
IC;% STANDARD/SUPPLEMENTAL DEDUCTION FORM
State Form 5473(R18/1-20) HC10
,.,. :P Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Security,driver's license,state identification and federal identification numbers are confidential under IC 6-1.1-12-37.
CERTIFICATION STATEMENT
I(We) Brent Pritchett certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following described real property under contract for which a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed, 11/2/2020 (date of signature). I(We):
17 Own. ❑ Am(are)buying under recorded contract.
❑ Am (are) entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust.
❑ Am (are)the shareholder, partner, or member of the entity that owns the property.
)
CONTRACT RECORDED
If buying on contract,Fee Simple owner's name
Recorders office where contract is recorded 'Record numb. -.ge
y _
PROPERTY DESCRIPTION
County Township Taxing district(city,town,township) Op
Gibson Princeton Princeton ,
Parcel number Legal description Is the property in guestiej//QQ.,,,,, Z
26-12-07-202-002.219-028 NS LOT 2 PT R3 2Real property �t5�f0� sassed mobile horde()C 8-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately surrounds that structure is used to produ end.b' •e the use and portion
of the property utilized to produce income. V& `�;
.Vry at.
PTO.
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is claimant vacating a homestead?
❑ Yes m No -
S/grt9tur of claimant
piI hereby certify the above statements are true,correct,and complete. X
Address of contact(number and she city,state,and ZIP code) /� Address of vacated homestead,if any(number and street,city,state,and ZIP code)
821 E Spruce St. ,C\V �\-CQ �� "
ASSESSOR USE ONLY I ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
Land not exceeding one(1)acre immediately
surrounding residential improvements (1) „
Other land (2)
Total land(line 1 plus line 2) (3)
Residential improvements or Dwelling (4)
annually assessed mobile/
manufactured home Garage (5) ,
Other improvements (6) .
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,year)
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
STANDARD DEDUCTION ALLOWANCE
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000.
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $
that is not assessed as real property or to a nufactured home that is not sessed as real property may
not exceed one-half(1/2)of the assessed v u of the mobile home or man factured home.
Signal r Auditor . Date signed(month,day year)
DISTRIBUTION: Original-County Auditor,File-Stamped Copy-Taxpayer
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