Homestead_Barrett (5)..•_.,
e.1 `°" °Y CLAIM FOR HOMESTEAD PROPERTY TAX
i' �'
CREDIT/STANDARD DEDUCTION,
,. .�� . ��� State Porm 5473 (R2/5-92)
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INS7RUCTIONS: See reveise side foi liling instructions.
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FORM YEAR
HC10
• - - ' ' GERTIFlGATION STATEMENT ;dClOa 1 ° •+�—
e) _� i. �.,. ...._ ��.j��g� .. � certify that o e 7st d y�M� �-�
��) occupied as our principal place of residence ihe tollowing described real property for which a Homesiead Prope x r�v���� imed:
�I (We) owned ❑ Are. buying under contraci . , .
Have a beneficial interesi in the eniity that is liable for the property taxes on the property and that owns �he property or is buying under a conirac[.
� � . -� . -0ONTRACT-RECORDED � �
It buyirg on contract, Fee Simple owner's name - _ . .� . . - •
Recorder's oflice where contract is recorded Record number Page '
Caunry
PROPERTY DESCRIPTION
TownsNp Tar�q disiric� (ciry�fown. township)
u
. - � � . . . � "�' �
Parcel numher Legal description
`,�O �c - ��%S8' - � - .
It any ponion of ihe residential sirucmre or ihe tand not exceeding one (7) acre that immediatey surrounds that structure is used to produce income, tlescnbe ihe use arW portion
of the properry utilized to produce income.
ASSESSOR USE ONLY TRUE TA% ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediarety
surrounding residential improvements. (�)
Oiherland (z) ,
Total lantl (line 1 plus line � (3� �.
Dwelling (4)
Resideniial improvemenis
� Garage (5)
Other improvements (6)
Total improvements Qine 4 through lina � (7)
Total value (line 3 p�s line � (g)
I hereby Certi�y Ihe above is ime. correci, and Signawre of Assessor Date signed
complete.
�Ying action - SignaWre of Auditor Dare signed
79_Pay79_
Lesser of 7/2 Homestead
Valuation or 52.�00
�EDUCTIDN ALLOWANGt
S
signed
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
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261
SIAR,lOAM �)'M �R`/�N�
iRE15URF0.fOR4:S1A
InJividuals md m�nied <ouple� are limited io orc homewead �andaN dedu7ion. As �hz �eceip� of ihis dteluc�ion becemes
mere beneSciaL thrre is morc incentnc tlnn e�er for M1omnttad fnud Ilome�ead (reud aases hieM taa bills for all: therefne.
HEA 134-i-?I%W requirts u�papm who remire �he hanesmaJ s�andarJ �4.ifunion �o verify tha� �hey are cligiNe io recei�e �he
benefi �ani m p(m�ide aklitio�l fdenun'in_ infomiatwn Mtt..'vn� ro eliuv.' eounn� gm'rmmrni ro be�mr mmiror homes�eatl
filin�,�. 7Tis informa�inn xill M Aep1 cwtidential anA nn nnl}' he aacexml Fr nWhnrvavt cnum�� nRciul.. The Ikpannrent of
Lueal Gu�'emmrnt Finance will u.e �his fniur.nation ro ar<att �wls �hm will h:Ip eounn� officials eliminarc hcmnateaJ (rnud.
Dennis V/ Jane A Barrett
2096 SW White Church Rd
Princeton IN 47670.9322
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Taxpaver Name
Barrett, Dennis V/ Jane A
V1NCF,v1-
State Parcel Number
2611-14-100-00�.658-027
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g�Addrtss(numberand>rmct,ciry,smte,and'LIP2ude) "-" - '
a o 9 Co 5 w cv �-, �� � N ti rr�N
Sccurity Numbcr (last 5 digiLS) Driver's LicemU$utc ID Nmnbcr Qan 5 digiB)
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Propertc Address
Rr 1 13ar 61-c
47670
Leeal Descriotion
006-0365&00 PT NE NW 14 2 11 1.36 AC
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�AR#� Err
� Swne a. property udd.�_'
RD� PR�N�E7o�, �-�
O�her (pleuc specify in Part 4
v`� l� R (? Ei7
e Address (Number md sYree4 rity, state, and "LIP cak) �me as pmpeny addres
Stturity Number (lasc 5 digi�s) Driver4 Limnsc/Sta[c ID Nwn6er Qazt 5 digits) Other (plcsse speciF fn Pan S bclou')
'i�[�7o —I - —
mdersiened certifies, under penalty of perjury•, that the abo�•e and foregoing infonnation is we and corrzct and that he or she is elieible to
e the homestead standard deduction on this property. Each undersigned�aiso unders�ands thaC byclaimingadditicoal homestead deductionc
fully, he or she may be liable for 6ack taxes and substanrial financial penalties.
I Signawrc Ihtc Tdephonc
�w�%, I/ � Q�-e,7� s�s�� (
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