Homestead_GillihanCLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT/STANDARD DEDUCTION HC10
` � Sate Fam 5473 (R8l 7-07)
Prescnbed by Ihe DepaMierl af Loml Gwemment Finance
INS7RUCTIONS: See rererse side /or filing insWctions.
I(VJe) �_ V c`e�th�t oa t�eJ� day of March. 20_
1(We) ocwpiad as ou ' dpal place of residence the folbwing described real properry for which a Homeslead Pmperty Tmc Gedil is hereby daimed:
� I(We) owned ❑ Are buying under contract �Q� C�
�Have a benefidal interest in the enfity that is IiaWe tw the property faxes on Me property and tliat ��NepropeJrryf AUDITORunder a contrad.
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If byvig on conUad, Fee Simpe wmets name
cmUaa is recntled
Tamship
Taring
n r Legal descriplion Is Ihe prq
-I s -.30D -0o � • -0 �^I
If arry portion of the resideMial siructura a Ihe land nIX exceedirg arre (1) acre lhat immediately surrounds Ihal
of Ihe p�operty ulilivd b produce incame.
Recmd number � Page
w�m u Mo��e Frome �ic �-,. v-n
used to produce incoma, Cescribe Ihe use and portion
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LarM not ex�rg t (w�e) acre immediatey ( � � _ �Y4 -, ` 'ti � ' .. . _ .
surtounding residential improvements. �- -
-.,, ,j- i - -
Other land (2� ,_.:�i,:.,�>�j;a:,, .`�1
; :;,-`..
Tdal W`M (line 1 plus Gne 2) (g�
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Residential improvements wMnualy �Ilirg (4) . . .. . - ' ..� _ -.
hssessed Mobile / Manufaduretl Hmre . .
Garage (5� .
Other improvements (6) . .'
Tdai imprwements (line 4 through line 6) (7�
Tcta� value (line 3 pl�s line n �g�
I hereby cartify the above i5 We, corred, erM Signawre ofASSessor Date sipned (monlh, tlay, yearj
camplete.
Vaifyirq adion - SipnaWre Mlwditor Date signed (monih, day, yea�
S PeY2�—
Lesser of 12
Homeslead Valuation
a „
45,000 for 2007 pay 2008 42,000 for 2010 pay 2071
44.000 for 2008 pey 2009 41.000 for 2011 pay 2012 $
43,000 for 2009 pay 2010 40,000 payable after 2072
mmry, e� y^
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Gibson CountyAuditor
101 N. Main SUeet
Princeton,IN 47670
1149
Justin Gillihan
2694 E Hwy 64
PRINCETON IN 47670
i
STAT£ FOPM
LOl
' � TNFASCPtAf00.NTS�lA
P0.E5[218m BY TIE OEPARTME\T OF I[1('N. GC\'ER\MEY! FlN� VCE IC 61.1-IIdl
Indi�iduals and married muplcs are limitnl m ane Mmmead standard deduction. As ;he'receipt of �his dcnuction 65camw '
morc brneficial, thtrc is more inrenti�r t}un nxr for homcstead fnud. Homestead Raud causes higl;ci ux bills for all; chere(ore,
HEA 1354-?009 rtquirts tacpayers wfio mcci�z �he 6omesicad srandard deduction �o vcrify that c6ry are eligible m rccenc the
brncfit and to prm�idc addiiional idrntifying infomu�ion nttcssary b allow' county gm�ert�menl to bener monitor homestead
filings. llils informuion xill•be kcpt ronfidcntial and can oNy bc atttsscd W authorized counry atiicials. Thc Dcpartmrnt of
Iqcal Gm'emment Filunce x�ill use this information co uearc tuols that will helo cown� officials �elimirum Fromrstead fizud
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TaxpaverName
Gillihan; Justin
. LowtionAddress
I,.
- ` 2694 E SR 64
., PRINCETON IN 47670
IW�III �I�I�III�III��IIII�IIWI���II�II�III�II���
State Parcel Number Lec
26-12-15-300-001.432-027✓P7 Sw i52 t0
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This form MUST be returned to County Auditor's office
Please do NOT send this form back with your tax payment to the coi
��rf�' �
Idress (number and �trcc4 ciry, s[aIe, and ZIP code)
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I"' Is�
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�lu II III
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treasurer.
ne as property addm55 ..� _ .
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o�nR �i� ��� � r� aln�iow�
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undersigned certifies, under penalty of perjury, that the above and foregoing infortnation is true and cortect and Ihat he or"she is eligible ro
�e the homestead standard deduction on this property. Each undersigned also understands that, by daiming addirional i�omestead deducrions
Jfully, he or she may be liable for back tazes and subs[andal financial penalties. �� � � �
1 Signature ',, /�� . - Date Telephone � - - .
G� . �X�'�'_' ` - �;,?� i/ (��� ) (� � � _ ��/ � .
'Si vae pyti Telephone / � � -
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