Homestead_Carter (4)n.
t CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fwm 5473 (RB / 1-03)
Presfiibed by Ne Department of Local GovemmeN Fnance
INSTRUCTIONS: See reverse side Ior Iiling insliuctions.
FORM YEAR
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I(We) � t° S� iL o� ��.a_.i�� V7l�Y-+--¢� certiry�that on the-7sl day o( March�!20 i/
� 1-ui,^i"'i!(i'✓ %�`^^-LT�;
I(We) occupied as our principal pla of residence the fol wing described real property for which a Homestead P�roperty��Tac�Credit is hereby daimed
�I (We) owned ❑ Are buying under wntract �
n Have a benefidal interest in the entity that is liable for the property taxes on the property and that owns the propeRy or is buying under a contraU.
116uy'u�g on conVad, Fee Simple ownefs name
Remrders olfice where conVaG is recorded
r-3r��� � ��x'��`���
County Tamship
town, towruhiP)
rarwinumcer � I � 1 � � � ' c' /-'// / �vl (QCa.0
� � �Tll�' (e- C�c a � a�
It eny portion af Ilie residenUal aWCWre w Ne land nd exceeding one (1) acre ihat immediatey surrounds that
of the property utllized tn produce income.
j�;� ��.`�e''h��'������PROP.ERTY-0ViINED:BY'CLAIMANTiM;OTHER'�
Counry Toxnship Coumy
I hereby cerlify ihe above statements are We, corred and complete.
Address(numberandsheetcity,afate,Z/Pcode) '
1 �,� z1 �D�' Z�1�/ i✓r.rco�a�
Record number � Page
in question:
�s►� P�oa�m ❑ Mobile Homo (I.C. 67.7-n .
f re is use0 W produce income. desrribe Ihe use antl ponian
-laimanl //�� �
'��� ( �G /� fL ✓
p�� �4 �"°�"`�'`'�'''��`k�� �'���TRUEaA�TAX ���ASSESSEDyALUE t NOMESTEAD� '� O RESIOENTIAL A
�� ASSESSOR USE ONLYe 'R.F �.t v-v q� �� - y���
�.��`t��;�q,.gs� g�`,�=r�.�.�m'��a��_'�" �VACUE���� xAT.i70%O �TfV� �,,�-.�VALUE�ys.z�• s�.-L�yVALUE�� s•.r.
Land not exceeding 1(one) acre immediatety � �+�' �.� ;.� �` -, ��n'�''
suvounding residential improvements. ( � z ���_.� � :.
Oiher land `�`�` � ��
�Z> =€�n��'"�
,�- �xraev __:.Y?.�".ss�
Tdal land (line 1 plus line 2) (g�
� ,t`s-v �iTi_ �"'- �,,�
Dwelling (4) ��; �ry .� �' --" +":
Residential improvemenffi or MnuaDy �'� �' 4'-����
h �
0.ssessed Mo61b / MerprfacWred Home Garage �5) �5u�����'�`������
Otherim rovements -����Y�t r
P �6) �'i:e ��
To[al improvemenLs (line 4 through line 6) (7�
Tdal value (line 3 plts line n (g�
I hereby tertify Ihe above is We, corted, and Signature otAsseswr Date signe0
complete.
Ve�ifying action - Signature oflwditor . Date signed
.,.... � c.q�,r� , �r rg,�.�.�.�e„ y -F"
'� -.,. ��`�-.t,__e'.�ti,<,a+ctT.�'�S-"�«+'�`>'cu��fi°'�"-"STANDARD'.DEDUCTIONALLDWAHCE;'_.e�-'�i��`.:��Y:�nu`'�r�"`&�.°t�'�za��4�.,�`,'3°�i�t',�r
.._.. �.. �-. � ....
20 _ Pay 20 _
lesser of 12 Homestead
$
Vauanon a f35.000
Signature ol Aud" " Date signed
:� -
° �
478
Gibson CountyAuditor
101 N. Main Street
Pnnceton, W�47670
� SiATE
PRESCFIOmBTTIfEUFP.�NiME\T
IAFA$UREAi00.NI$�IA
individuals and nurried mupla are.limited to ane homestead standa�d Jeduction. As the rtteipt af this deductim hecoma
mare brneficial, ihcrc is more inttntive than e�rr for homestead Gaud. Homesvad (mud rauus hi�her tax hills for all; t6ereforc,
HEA 13M-?009 rtyuim eaxpa}crs aiw recerve �hc homestead stmdard dcduc[ian to �rrify cha[ [6ry are eligible lo rttei�e llrc
bcncfit and to p`m�ide additim�al idrnli(ying informntion necessery to nllm�� county grn�cmment b beucr monitor homcstr�d
filings. ltis inCormation will be kept canfiden[ial and can onW be accesscd by au�horiud munty atiicials. 7'hc DePartrtrcnt of
Enc Carter ,
_ 1050 S 350 W
PRINCETON IN 47670-8156 `
I�II���IIJI�LI�II�h�l�l��l�hl�y�l��ly��������yllll�ll�����
Taxpayer Name
CaRer„Eric� `
Location Address '
iosa s 3so w
PRINCETON IN 47670
I II�I�III��II) �II �I �III �II IW�IIII�II�II��II�II�II�III�II (� IIIIWUII IIul�lu II II
State Parcel Number Leaal Description
6 1 S3 7 027 �PT SW 15 2 17 9.509 AC D-17 -
����� � _. . ___..,
' MAY 16 2011
c.�.� y
v�
� - - GIBSON COUNTY AUDITOR �
This form MUST be returned to County Auditor's office.
Piease do NOT send this form back with your tax payment to the county treasurer.
� � � � .. �,� � I �� ....�...�
.ddrzss (numbcr and stree4 city, siau, and Z[P codc) �� . `n
O� O J �� �O � �. �I ��_�CL\1�`
vriry Number Qast 5 digitsl Drivers LicensdSiate ID N�ber (last 5 digits)
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Samc es property addicss �
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Otha (pleau specify in Pazt 4 below)
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"'— - . .. '❑'S�:inc"dspropcnya
[D Numbei (last 5 digia) Othcr (pleau sp
._I � Sm¢
Fach undersigned certifies, under penalty of pepury, that the above and foregoing infortnation is We and cortec[ and tha[ he or she is eligible to
receive the homestead standard deducrion on this property. Each undeni�eA also undecstands that, by claiming addirional homestead deductions
unlawfully; he or she may be liable fo�ack ta�ce�c and substantial Einancial penalties.
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