Homestead_Smith (85) CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
-,,,; STANDARD/SUPPLEMENTAL DEDUCTION HC1g 2022
State Form 5473(R18/1-20)DepartmentIt 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) Briana J.Smith certify that I(we)occupied as my(our)principal
place of residence or am(are)buying the following described real pro�t rty nrder on r which a Homestead Property Tax Standard
Deduction is hereby claimed on the date this application is signed, —1 -Z_` ' t.- (date of signatut4. I(We):
la 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.
If buying on contract,Fee Simple owners name
Recorder's office where contract is recorded Record number Page
PROPERTY DESCRIPTION
County Township Taxing district(city,town,township)
Gibson Princeton Princeton
Parcel number Legal description la the property in question:
26-12-18-103-001.723-028 ROBERTS PLACE 3 2 Real property ❑Annually assessed mobile home(IC 6-1.7-7)
If any portion of the residential structure or the land not exceeding one(1)acre that Immediately surrounds that structure is used to produce Income,describe the use and portion
of the property utilized to produce income.
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,end Township Is claimant vacating a homestead?
'`'�❑ Yes Yes 0 No
(\�J�,
I hereby certify the above statements are true,correct,and complete. MeV , n ,, .'1
Address of contact(number and street,city,state,and ZIP code) • •r of acated homestead,if any(number and street,city,state,end ZIP code)
1008 S.Hall St.,Princeton,IN 47670
ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL
ASSESSOR USE ONLY VALUE
Land not exceeding one(1)acre immediately (1)
surrounding residential improvements
Other land (2)Total land(I/ne 1 plus line (3) _IFILE")
Residential improvements or Dwelling (4)
annually assessed mobile/
manufactured home Garage (5) APR Other improvements (6) APR 21 202Z
Total improvements(line 4 through line 6) (7)
Total value (line 3 plus line 7) (6) •tc m y
g /� V
I hereby certify the above is true,correct, Signature of Assessor C,IBSON COUN R
and complete.
Date signed(month,day,year)
Verifying action-Signature of Auditor
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 manufactured home that is not assessed as real property may
not exceed one-half(1/2)of the assessed value oft :home or manufactured home.
Signature of Anil /.4^ ,S C D>kig th,c y,ye a
W\ 'Vrytf^``lN^`J i ....2._
DISTRIBUTION:Original-County Auditor,File-Stamped Cop, - .
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