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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 5473 (R2 / 592)
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INSTRUCTIONS: See reverse side lor iling instructions. '
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CERTIFICATION STATEMENT �/ �--� _ �,�SA�� • '�
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1(We) e,�y }� Y( G� �1/ \ G'� 1 11 e j� �C� certify that on the 1 st day of March, 19_
I(We) occupied as ur principal place of residence the tollowing described real property for which a Homestead Property Tau Credit is hereby claimed:
�(We) owned ❑ Are buying under contract -
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns ihe pioperty or is buying under a coniract.
CONTRACTRECORDED -
If buying on conVact, Fee Simple owners name
Recordefs office where coniract is recwded � � Recortl number Page
PROPERTY DESCRIPTION �
Counry Township Tacing tlistrict (ciry, to• , township)
Parcel number Legal description
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If any portion of ihe residential suuaure or the lantl not exceetling one (1) acre that immediatey surtounds Ihai swcture is used to produce incrome, describe the use and portion of
the properry utiiized ro produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township Counry Township
Siqnature of claimant
,ereby certify the above statements are true, correct and complete. �� �,
Address (numberana streeG ciry, state, ZIP code�
Q I 13oX 287 ��tucEroN �N 47G2o
ASSESSOR USE ONLY •TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VAWE VALUE VAIUE _
Land not ezceeding 1(one) acre immediately (�� . �
surrounding residential improvements.
Otherland (2)
Total land (line 7 plus line 2) �(3) .
Dwelling (4)
Residential improvements
Garege (5)
Other improvemenis (6)
Total improvements (line 4 th�ough line 6) (7)
Total value (line 3 plus line 7) (8)
1 hereby certiry the above is true, covect, and Signature of Assesor Date signed
complete.
Verifying acUOn - Signature ol Auditor Date signetl
� STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesserof 1/2 Homestead c�
Valuation or 52,000
Signature of Auditor Date signetl
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
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nnmm'[o er �r�ie erwxurcnrrr.w�ic. v..
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MASIIRCRiORM:SIA
InJi.�iJuaL. anJ rturrinl couple� are limiied io onc hortrcsead �ta�MaN d.Munion. As the recerp� of �hi> dedunion bttonres
mere brmficial, ihrre is more incen[ne than aer (or M1omnteael fiaud Ilomea�eaJ fmud caa� hi�M ta� bills tor all: ffierefur.
HEA I;i-i-?009 rcquim usparen wh� receirc Ihc hanes�eaJ standard JeJuc�ion m.crify ihai �hey are eliciNe io recrne �he
benefit ani ro pnn'ide :uklitiorial idemifyin� infurmanun ncerssan� �o allw' counq� gmemmrnt �o b[¢r monimr homrn<ad
filin2. lhis inlomwinn will M Aqv ronliiiemial and can nnl�� h- avae+�ed F�� aulhorieni coumg oRcials. The IXpanmcnl nf
Local Gm<mmcm Finance will u.e this infom�atiun m ercaec uxils tlu� mill heln m�nvr nffiNak rFminnm Mnn�e�..d fi.��d
_ Taapaver Name Pro em• Addre�s
_ Carlile, Michael E/ Marsha J r
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Prince�an 1\ 37670
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�Michael E/ Marsha J Carlile �� !i/ // /
R7 Box 287
Princeton IN 47670-9272 ��J� State Parcel Yumber Leeal Descriotion
I I II I II I I II I I I II II � II I zf'�2-�8'403-000.412-027 006-00412-00PTS18210.686AC
in wi n� niini� innin i nni i D70
This form MUST be retumed to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
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Owucr I First _ Middl< . Lazt
I�iiC�'�de� E �r��le
�g Address (number und strec4 ��ty. sm�c, and ZIP code) �'$nme ns pmpem oddress
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Social Security Numbrr (last i digiu) Drivas Lice2ad5taie ID Numbcr (laz� 5 di�its) Othcr (pleuc sptcifj in Pan 4 below)
S{aLL;c First Middlc Lut
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Mailing .Addrtss (i�umber and �trce4 cil)', slale. and "ZIP coJe) S�une as pmpeny address
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Social Stturip� Numbcr (latt 5 dieits) Drivers License/Swre ID Niunbcr (lu� 5 dieits) O�hcr (plcvsc �pecify in Pan 4 bclow�)
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Each undersiLmed cerrifies, under penalty of pequry•, that the above and foregoing infortnation is trve and wrrect and that he or she is eli4ible to
receive the homestead standard deduction on this propeny. Hach undzrsiened al>o understands that, by claiming additional homestead deductions
unlawfully, he or she may be liable (or Aack taxes and substantial 6nancial penahies.
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