Homestead_Dobson� CLAIM FOR HOMESTEAD PROPERTY iAX FoRM YEAR
t CREDIT/STANDARD DEDUCTION Hc�o
t � State Farm 5473 (R6 / 403)
Prescribed by the Department d Local Govemment Finance
INSTRUCTIONS: See revcrsc sidc !or liling insf�uclions. � T �i �� �
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��e) � T' erti(y �hat on�tEie�lst day d�iFh, 20_
I(We) occupied as our principal p of residence the following descnbed real property for which a Homestead Property Tac Credit is hereby daimed:
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❑ I(We) owned ❑ Are buying under wntract `—�/ �
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� Have a beneficial interest in the entity tha� is liable for the property taxes on the property and �hat owns the property or is buying under�a�conVact.
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I( buyinq on conVaG. Fee Simple owners name
Rem�ders olfice where conVad is recorded
Tawnship
- Oa IS � ���
tl any portion of Ne resitlmtial sWqura w the land
ol lhe ploperry ulilaetl tn produce i�ome.
Record number � Page
Taing tlistrict
Is the property in question: �
� Real properry ❑ Mobile Homo ILC. bf.
one (1) aue that immediatey surrounds that swcwre is used to protluce income, describe Ne usa and portbn
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
2269
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Indiriduals anJ married muph are limited io onc home�eaJ �andaN dnluninn. As Ne rtcript oi il�s dcJuction bccnmc:
mere benefidal. thrrc is more incrntire than r�er (or homriteaJ frauJ. IlomesrcaJ fraud cau_� hi�her tac bills tor all: thercforr.
HEA LiA-f-?OQ9 requves taapa.en x�ho rrceive ihe hanestcaJ sundaN JeJuc�ion io reri(y ihat they aml��{tiMe to �ccri�c Ihc
bznefi� ani ro prtr.�idr mWitional idemfiri� infumianun nemsary to alluw counn� gwrmmrnt eo Ntitt muniror honrsrcacl
filina. ILis intormation xill be Aryu cmlidenlfnl anA can only h acet:ceJ by awhnri�eJ rnw�ly n(licia�c_'fhr IXpannrcnl n(
Local Gwcrmnrnt Pinanm ��ill u.e this in6rtnation tu cream tmis Ihat �viil hcln munn� utTicialx diminarc homcstca�l fiauJ_
Taxpa��er Name
Dobson,Jim R/Barbara R
Jim R Dobson .
R3 Box 143
PRINCETON IN 47670-8669 Stare Parcel Number
�i�u������������ui���ui�n�n��in��u���ui�i������������� 26-12-06-201-002.154-027
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1'rinceton IN d7670
OOfr02154-00 LAKE
er I Firstl Middle
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d$murity Number (last 5 dieits) Uriver's License/State ID Nmnber Qasi 5 digiL�) Other (ple.�se spccify in Pan 4.below')
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Ng Address (�umbrr and streeti ci�y, s�a�e, and "LIP code) � S:un<u pmyem� addresa
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d'Saurirv NumFcr I,lazt 5 dieiti) Dri�rr's Liccnu75u[c ID Nw�ber (la � 5 dieit=) Oihcc (plrvc spccify ir. Pan 4 belox�)
SUB DIV 2l3
mdersigned certifies, under penalry o( perjury•, [hat the abo��e and foreEoing infortnation is we and cortzct and that he or sHe is elieible to
e the homestead standard deduction on this property. Each undersigned al>o understands that, by claiming additional homesiead deductions
fully, he or she may be liable for back ta�ces and substantial financial penalties.
1 $ignznuc ' Datc Tcl<phmc i
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