Homestead_Clarkd�•�., CLAIM FOR HOMESTEAD PROPERTY TAX •
�37""-y : CREDIT/STANDARD DEDUCTION�
;� State Form 5473 (R2/1-90) "
�' '•�• � INSTRUCTIONS: See reverse side for filing instructions.
� CERTIFICATION STATEMENT -
I -(We)
.FORM
HC10
certify that on the tst day of March , 19
�
(We) occupied as our principal place of residence the followin scribed real property for which a Homestead
'roperty Tax 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 propert and that owns the
property or is buying it under a contract. � g� ��
If buying on contract.
Couniy
contractisrecorded
Township
CONTRACT RECORDED
ame
PROPERTY DESCRIPTI�I
Legal Description
Record I
;ity, � , to�
v - V �- d'
If any portion of the residential structure or the land not exce ding one ( 7) ac e that immediately surrounds that'struc- '
ture is used to produce income describe the use and portion of the property utilized to produce income.
County
rhereby
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Township C
certify�Tre above statements are irue. correct and � I �SI natur (�' �
� C
;(Siree . number, city, siate d ZIP co e)
fmv�< Dv�ve t�u�tiee�oH,,1HC�� . ��6�70
ASSESSOfl USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE
NON-RESIDENTIAL
VALUE
Landnolexceedingt(one)acreimmediately '
surrounding resideniial improvements (�)
Otherland (2)
Total land - line (7) plus line (2) (3)
ResideniiaFimprovemenis Dwelling � (4) - - - - -
Garage (5)
Other improvements (6)
Total improvements - line (4) through line (6) (7)
Total value - line (3) plus line (7) (8)
I hereby certify the above is true, Signature of Assesor Date Signed
correct, and complete
Verifying Action - Signature of Auditor Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 7990 1990 Pay 7991 7991 Pay 1992 19—Pay 19—
Lesser of 7/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead Lesser of 1/2 Homestead
Valuation or $2,50Q Valuation or $2.000 Valuation or 51.500 Valuation or 51,500
:i "
Gibson County Auditor
101 N Main
PRINCETON IN 47670
1748
r. �
I
SIALElOR,N!) W IIL'/ �'NI
nr�suauronvsu
Individuals and irt�:ricd couplc.. arc limi�ed io nnc homcsteaJ aandaN d:�lucuon..4 �he reccipt ot tNs dcJuction bttm�n
murc benencial, thrre i. morc inantire dun e�rr for homeitraJ 8aw1 Ilomr�xal f2W causa higher tac bills (or all: �hercfar.
HEA liii-?O(19 requirts uxpaycn .no recei.c the hanestcad siandarJ �vfuction u� veriF tivt tM1ev am eliciNe m recei.e �M1e
benent aml io pnn�ide :�Yfiiional iJrntiiyim� infumiatwn necnvn ro albw countc gucrmment �o Nt¢r moni�ur homcsu:Kl
filintn�.'Ihis infnrma�inn will be AryM crntidcmial anA t�an only h� acmuA hy amMrircd rounly n0icivls.'Ihr Ik�unment nf
Lucal Gmcmment Fiium�< ��ill u.e �his iniorma:ion w crca:c hvls �hat will help rpmp� ohTw.ials dimfnaic homestcad fiaud.
. � � � . �
Taxpaver Name Propem� Address
Clark, Donald E I/ Debra
Donald E/ Debra Clark I I
667 W Paric Ave
Princeton IN 47670.2812
I�I��II���I�II��I���II1�����1�11��1����11��1�1�11��1���111���1
667 N' Park Are
Princrton IN 47670
State Parcel Number Le�al Description
26-11-13-202-001.920-027 oofr07924ao POP�aR HILLS 4
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