Homestead_CritchfieldCLAIM FOR HOMESTEAD PROPERTY TAX
- CREDIT/STANDARD DEDUCTION
♦ � Stata Form 5473 (RS / 10-01)
°p Presaibed by �he Department W local Govemment Finance
� INSTRUCTIONS: See reverse side 7or (ling instructions.
FORM YEAR
HC10
� � � ���
I(We) � certify ihat on tha^st day o,f M�% ch, �2j0�
I(We) occupied as our principal place o( residence the following described real pro rty for which a Homestead Property �Ty�ID�-c �C- �edi is.Te7eby-daimedr-�c
❑ I(VJe) owned ❑ Are buying under contract /° GIBSGN COU1fTY AU�ITOR
� Have a benefidal interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract. i
If buying on conVap. Fee Simple ownefs name
Remrders olfica whwe con4aq is recorded
��afEd�w'`cr.a.a::<�sczu`�L�'�, .�r'�.,+w
County � 7avnship
eistrict (riry, mwn. rownshiP)
Record number � Paga
�P cel numDer L descripGon Is the pmperty in question:
l�-�OS34-O� t11LJ��, 33-a-1� oR�wo,�m ❑MOD�eHOmo(I.C.6f.f-�.
H any portion of Me residenilal nWCWre or Ne IanA nd exceedinp one (1 � aae Nat immetliately wrrounds that snucWre Ls used b produce income. deSUiDe the use ar�d portbn
of the propery uuT¢ed tn produce irkome.
�• Rc.
County
Toxnship
I hereby ceAify the above statemants are W e, corred and complete.
street, ciry, atate,
of
To.vnShip
�,. -
•
Gibson County Auditor
101 N Main
PRINCETON IN 47670
�
4166
llAi! f(10.M a�µ 10. / fwl
A��NT'fIIBY �t\IE Bp1POOF.MY�I.\T�. _Vv
PA(_CRIBQI BY
1RF.WI�fRi00.V:S-IA
6idividuals anJ nu:rieJ muple: arc Iimi�eJ io nre hnmcacaJ uandaN deAunioa A> �he rcccipt ol' Nis deduction bcconre�
murc beneficial, thrrc fs morc fncrntnr tlun r�er for homesmaci fraud. Home»ead &awl cau.�s higher ta� bilis for all: thrrefar.
HEA I3+1-?009 requim tanpa�m who �ttrivc ihc hanestcad sWndvd �trfuction tn verilv tlwi ihcy me diciNe to recei�e dn
benefi� an1 to piw�ide additio�ul iJenniyinc �nfum�mwn nec�'vn� ro allw' county gmrmmenl �o bener monitw honxs�<:d
tili�,�.'Ihis in(ormation will M Ae7w ernti�!emi�l anA r.m only M: arersseJ M1y nutMriinl rnunt�� n(Tciul_.. Thr Ikrywnnrent of
Dennis Wayne / Critchfield
2025 E 350 S
PrincetonlN 47670-8746
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�oo-S E 3SaS
Social Sccuril} Nun�bcr (last 5 dieiLC)
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Prnoem• Address
R? Boa l05 ��
1'rinceton IN 47670
Leeal Descriotion
006-00534-00 PT NW NE 33 2 10 2 AC
D-10
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(plcssc spccif,v in Pan 4 below)
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� Same � prayeny addrtas
(Plcuc spccify in Pan 4 bclow)
mdersigned certifies, undzr penalry oiperjury, that the abo��e and foregoing infurtnatiun is we and cortect and that he or she is elieible to
e the homestead standard deduction on �his property. Each undersigned also undemands that, by daiming addiiional homestead deductions
fully, he or she may be liable for back taxes and subsianiial financial penal�ies.
I Si c Dzv- 7'cicphonc (
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