HomeMy WebLinkAboutHomestead_StockeCLAIM FOR HOMESTEAD PROPERTY TAX � FORM YE�'R
r - � � CREDIT/STANDARD DEDUCTION �
State Fortn 5473 (RB / 7-07)
•� � Prescnbed by Na Deparimeni oF Loral Govemment Finarrce .
INSTRUCTIONS: See rewrse srde lorfiling instiuctions.
I M�e) .� �� (!J /Pf ,(' ��,� •iC�J cer6fy tha[ on���ch. 20_
�'��
I(We) occupied as our principal place of resbence the follo�wi/n/g{1 escribed real p rty for which a Homes[ead P���C�Aip�p�7Y8f�ed:
� 1(We) owned � Are buying under contract /]f/)/ < S/�
l //�' �J �O
Have a beneficiai interest in the entiry lhat is liable fa the property taxes uffhe property and ihat owns the properry or is buying under a contract.
If Gryin '
s
Counry
Paicel number
If any po �o o
of Ihe p
�/�_
Fee Simple ownefs name
c«,uaa
TawnsNp
� �//C� d� �o -�-,
residential siruclure or the land nIX ezceetling one (t) aue Ihat immer
9d In pmduce inmme.
�o- ��_ odo. �9/- �a�
.,. , , :
Twvnahip
I he(eby certity thB abave Statemenis aR INe, toRetl and compl@le.
5(number aM sLaeC city. slate and ZlPCOde)
'0 9 LC� �S`%/��_ fLQ lo
Tating disUicl (cily, la.vn. lmmshiD)
Is Ihe
wrtounds ihat
CouMy
Record number ( Page
a�oaenv ❑ Moa� rw� �ic s-,.,-n
use0 to produce inwrtre, descnbe the use e:d portbn
.� ec�f-.� .J Z
�oog U33a
cs.
�. , . . .. . .
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Land not exceedirg t (wre) aae immediatety . ': `: � --: ��'` . .
surrounding residen6al improvements. ��� . . . �
Other land �p� - . , _
Ttlal IarM (line 1 plus line 2) (3�
ResidentialimprwementswMnualy �e11i� �4� ' � ��"�`�1,-.�"
Assessed Mobile / ManufacWred Hwne - - '�
Ga29e � (5) -. ,, � . - � .
Other improvemenis (6) .
TUaI imprwements (line 4 through line 6) �7)
Total value (line 3 pl(s line � (g�
I hereby certify Ne above is We, cwrecl, and Signawre of Asseswr Date signed (month, day. yea�
complete.
Vaifying action - SignaWre of Puditw Date signed (manN. daY. Y��
� �.-� � � • •
�— PaY Zo _ 45.000 for 2007 pay 2008 42.000 for 2010 pay 2011
Lesser ot i12 qq 000 for 2008 pay 2009 41,000 (or 2011 pay 2012
Homestead Valuabon b
« 43,000 for 2009 pay 2010 40,000 payable after 2072 - �
SignaWre of Pudtnr Da�e sgnetl (monfh, day, yea�
- y F( 't�
l. J
Gibson County Auditor
101 N Main
PRINCETON IN 47670
�IiiE FOR\I!) W IR'/ NP�
TV S�AfRiOtVYln
InJividual.. and in�rriN coupl¢ are IimimJ �o nrc homcueaJ sandaN dMuction. As the �acipt o1 �hi. dNuaion btta�rcs
merc beneficial, thrrc is morr incen:ne thv� e�er (ur homorcad freW. flor�aeyl f`aud ouses hi�her tac Lilli irn all: �hnetar.
HEA 1i�41-?009 requvcs mapa.en who �mirc ihc hanesimd sundard deJunion in verify �Mi �hec ye clitible to mcen. ihc
brnefit anJ io pnn'ide aJAiiional identifyinc infwmntiun nrmvrc io allw� rounq� gm�rmmrni �o berter monitor humrsmaJ
filinga_ lhis infn�matinn w�ill be AeFV contidential anA cnn onlp M acvrsseJ M1y au�hnriml coumy n(fiti�,di.'I'he Ikpanmrm nf
Local Gw<mmrnt Pinanc< wfll ua this in(urma�ion W crcatc fiuls ihat will h:lp counn officials eliminate hum<s�<ad fnuJ.
• � � � • � —
Taspacrr Name Prnperh� Address /'
Dillon, James M/ Violet J �S� W S r� tj `�-
sk c,�
1437
James M/ Violet J Dillon
�
P O Box1294
PRINCETON IN 47670-0994
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Ou'ncrl First
1� I C �l N i'd �\ -
... .— �g Address (numbcr wd sacc[, city. smtc, end�ZlY code) -. `
�°o �ex �aq�
Social $
/��;s � M.
g Addre>'s (Numbrr and slrce4 �ily, stale, and ZIP cak)
Pd ��x i���-
;
State Parcel Number
26-11-10.400-000.491-027
V
\cw' llartnonr IN -07631
Leeal Description
OOCr00497-OONWSE 1021110.065 AC
D-17
S�o G�' ��
"Samc"as pmpcm odd�.i
S-�a c K �
� $ame u pmpem adaress
undersignetl certifies, under penalty of pequry•, that the abo��e and fore{;oing infortnatiun is [�ve and cortect and that he or
+e �he homestead standard deduction on this property. Each undersigned also understands thaL by claiming additional hom
✓fully, he or she mat� 6e liable for back taxes and substaniial financial penahies.
5-6-io
( gla) 38�- 3/�
�e-e�� 77'l� ?���� I 5'G-�o I ��'I�) 3 S'6 - 3/ o0
eli�ible w
I deductions