Homestead_Christmas�. ���`"""°< CLAIM FOR HOMESTEAD PROPERTY TAX
� � CREDIT/STANDARD DEDUCTION
� State Form 5473 (R2 / S92)
v ,__; ?
6
INSTRUCTIONS: See reverse side !or (ling instructions.
STATEMENT
FORM
HC70
YEAR
I(We certify t at o�e fsi3ay �ch, 79_
I(We) occupied as our principal�plac f residence the following described real properry for which a Homestead Pr�� T��re��hereby claimed:
❑ I(We) owned ❑ Are buying under contract
❑ Have a beneficial interest in the entiry that is liable for the pmperty taues on the property and that owns j�e proper�y or�s b�g undefp cc�}2ct.
Ii Duying on contracf, Fee Simple ownefs name
Recortlers
3555 -
CONTRACTRECORDED
PROPERTY DESCRIPTION
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
claimani
certify the above statements are true, correct and complete.
iumber and street, ciry, state, ZIP codeJ _
ASSESSOR USE ONLY I TRUETAX I_ ASSESSED
VALUE VALUE
Land not exceeding 1(one) acre_immediatelv_ __—_...
surrounding resideniial imprc
Other land �/_�i(,� ��� `a+Cl —
Total land (line 7 plus line 2) �O ���� —
Residentialimprovements , � ,lr�� 7\ —
�U� � �
Other improvements � —
Total improvements (line 4 th �j
Total value (line 3 plus line 7J L� "—" U �
I hereby certify the above is h
wmplete.
Verilying action - Signamre of Auc
79_ Pay 19 _
Lesser of 1/2 Homestead
Valuation or S2,000
STANDARD DEDUCTION ALLOWANCE
S
HOMESTEAD
VALUE
use
NON-RESIDENTIAL
VALUE
signed
�
�
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
�i\R FORN �!MIR'! 4M1
1RE4SIIlEAFORYZI�
PAF3RIBTOY t11f 4EPTRTME�T<i L(MAl C-0�2LVNR.T iP'AiCE ICH.1-DLI
IndiviJuaL. anJ �rt�:ricJ roupks are IimitN m onc homestcad 9andaN Jalu.�ion. A� ihc rcceipi of Ihis dalunion bcconrcs
more bemficiaL �herc is morc incentne dwn ner (ur homriteacl fnud I IonxzreaJ frnuJ caa�es h�her q� 6ills tor all: the¢fae.
HEA IiJ-1-3009 requircs U�pasen �ho n�ccivc thc hunenred standard �Yaluaion �o veriF du� ehry am clieiMe io mcenc ihc
benefit anJ io pnn�ide aJdiifonal identii�'in_ informanun nemarc to allw' caunn� eo;emmem w beuer mwitw IamrsteaJ
tJin��. This inla�mmim will he Aery mnfiAcmial and csn only h: avm..n1 M1c nwMrireA rnmiy otTicial..'Ihe lhpannmm o(
2155
Christmas Jackie
c/o Erin Lloyd
2738 Taftown Rd
PrincetonlN 47670-8616
I�I��II���I�II��I���III���I��I��II���„II�II����II�I��I��I��II
Ta�nacer Name
Christmas, Jackie
R3 Bo� i0 �
Princemn IN 47670
State Parcel NumAer Leeal Description
26-12-03100-703.559-027 oos-o355s-oo BLDG ON LSD GRD
� aos-ozosa-0o
I First Middle
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, .ud�cv'(nwiia.�r�rNSSx�;ti:j'_,a�e.-ard2:9.w:i— --_ ' _'__ _f.�l c=,.,.v=�FmM - rl..
LLJ
iecuriry Numbc� (laa i dieils) Urivers Lianu/Slatc ID Nmnbcr (lazi 5 digiLS) Othrr (please spccify in Part 4 yelow)
!/� ��
(Numbcr
�
city, sialc, and ZIP code)
Drivcr's Liccnsc/SU[c ID Numbcr Qac� 5 digits) Othcr
:¢ /- � '�
f� Snmc :u
4�
Pan 4
addr�
undersitmed certifies, under penalry of pepury�, that the abo�•t and foregoing infortnation is we and correct and that he or she is elieible [o
:e the homestead standard deduciion on this property. Each undersi¢ned al;o understands tha�, by claimin¢ additional homestead deductions
rfulh�, he or she may be liable (or back taees and substantial financial penalties.
I SicntRVC /� Uatc . .� Tdcohonc �/�