Homestead_BorofkaCLRIM FOR HOMESTEAD PROPERTY TAX
CREDR/STANDARD DEDUCT{ON
S�Se Fonn 5473 (R7/5-08)
Preaabed by tlie Depertrrent oF Laml GoreimeN FewKs
MSTRUCT70NS: See iaverse side lor R'vrg orsbuctions.
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tt dry'sg om m�tracl Fee Sirtv�e w�rere reme
I�co'dds of6ce whae mitract is recuded Rewd number Pepa
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Legal dmcrip7m
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tl arry partcn of tho resdaetial �ae aI Ne I�d nal mcceedirg ane (1) ac
d tlie praperty ufif�d b pioduce eimne.
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Is the poperty n quastiw�:
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� ne'eny oertity me anove stamrr�ents are aue, mrea ana conv��- %�`
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�� � ASS6SOR USE ONLY � '. � '� �"��� ���: ` 7i�lETAX ASSESSFD VALUE ,HOl�STEAD . vy �''�MONRESIDEt1ilAL'� � ��'
'+,i�' �' . i.'f4 y t ���E�r 'Ai100XiOF1'IV `�� tVALUE t� t. �r.yir�i.?� VALUEs..�.�,f��'t'�'?J
Land not exceedrg 7(one) acre imrt�ediafily •'. j� ti:� �` w�y�� �';='� �"�`'; ��'
s�afoundirg residential �mprovert�ents. �� � e r``�;���.:r;�r=� ^F �a���:'S�`S�iC1�i
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wssessee r�obae � Mar,ufam.ea Hon,e � e x� �{,�*�t;. ,��r,�.:.��:; �ir��.�,�
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Tdal'vnprovernertls (iare 4 tivax,� 6ne 6) (7)
Tdal value (I'cre 3 pds ffne n (g�
I I�y certify fhe above is true, oarec.t and SiBrretue of�u Dafe sig+ed
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�N��B aCim - Sgmhae dA�mr Dafe signed
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20_Pay20_
Lesser of 12 Hortiestead
Valuation or 535.000
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DULI��p FOR
(or
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: •' GibsonCountyAuditor
' �101 N: Main SVeet
� �Pnnceton,IN 47670
� FII,EI�
MAY 6 2011 °. °
n��
'- � Individuals and married mupla aze limited m one homesttad sta�dald dcduttion. As the rettip[ of this deductian hecomes
more 6eneficial, ihcre is more incentive�than c.sr for homrncad flaud. Hamrnrad (reud canas highcr tax bills for ali; tMcfom,
�� HEA 1344-?009 rcquires tazpaycrs who rcccitc ihe homestcad standard deductian [o verifi� [hat [hcy azc cligible [o rtten< Ihe
- bcnefii and lo provide additional idcntifi�ing in(ormation necessary b allox' co�inn gwemmcnt io bcncr monitor homcstcad
.' filings. Ttus information will be kept conndcncial and can only be acccsscd by author'vzd counry officials. The�Deparunrnt af
Lopl Gm'emmrnt Fiwrce uill use t6it information [o cream [aols �hat will hely cowty officials <liminate homestead fraud.
� � � � . �
TaxpaverName LowtionAddress'
C � rc�'� ° � Boroflca, David/Cheryl
GIBSON COUNTY AUDITOR� �, _, 1 X - �03 S�eo E
- � ` � PRINCETON IN 47670 ,�
1119
David Borofka I II�I�III�III� �II�I �II II�I I��IIII�II�IIII �II�II�II�I�II�II �III IIII�I �II Il�lul� II III
103S180E
PRINCETON IN 47670-8962
' �I�I����"���1'��I"II�IIII�I��II���'�I�'lll�l�illl�ll��illll�l�� State Parcel Number Leqal Description
26-12-09-302-002.181-027 PTSW 92102z48AC F c-7 .
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This form MUST be returned to County Auditor's nffice. '
Please do NOT send this form back with your tax payment to the county treasurer.
Bo co�i'��-
�-s�� � P�any �aaras
Othcr (pleau ipeci(y in Pen 4 bclow)
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ancr (pteaze sp
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undersigned certifies, under penalty of pequry, that the above and foregoing information is we and correct and ihat he or she is eligible ro
�e the homestead standard deduction on this property. Each undersigned also understands that, by claiming additional homestead deduction
�fully, he or she may be liable for back taxes and substantial financial penalties. , . .
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