HomeMy WebLinkAboutHomestead_Dickisoni�"`5i�"°< CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
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, State Form 5473 (R2 / S92)
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INSTRUCTIONS:_See reverse side for Iiling instructions. .
FORM
HC10
YEAR
RTIFICATION STATEMENT �
I(We) certify that on the 1 st day of Mamh, 19_ _
I(VJe pied as our principal place of r dence ihe following described real property for which a Homesiead Property Tau Credit is hereby claimed:
I(We) owned ❑ Are buying under contract ���q� ��, ,
❑ Have a beneficial interest in the entiry that is liabte for the property taxes on the property and that owns the prope�s�p�g u� �nq$ct.
9 A . . —. : L7�i
CONTRACT RECORDED �
If buying on convact, Fee Simple ownels narne
Recorders office where contract is recortletl � - Record nu r Pa
PROPERTYDESCRI TION ' ` '�.• `�V.... .V .�V.•
Counry Tovmship Ta�dng i rict �ry,�fo ship)
Pa e umber Legal descnpiion
p -�322s= � o
If any portion ot ihe residential structure or the lantl not exceeding one (1) acre that immediatety surrounds ihat sWCNre is usetl to produce incame, describe ihe use and portion of
the pmperty utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Tovmshi Counry Tovms ip
\
ignaNre Gair�ant
ereby certify the above statemen?s are true, correct and complete. ^
�Address (number and s�y, srafe, Zl�e) L
4 T L.i
e� w �,�
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAI
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately ��� �
surrounding residential improvements.
Otherland (2)
Totalland (line 1 plusline 2) (3)
Dwelling (4)
Fesidential improvements
Garage (5) .
Other improvements (6)
Total improvements (line 4 fhrough line 6J (7)
Total value (line 3 plus line 7J (8) , - �
I hereby certify the above is Irue, correct, and Signamre of Assesor Date signetl
complete. �
Verifying acoon - Signa[ure of AuOitor Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead � _
Valuation or 52,000
Signature of AWitor Date signetl ,
I 1
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
2813
tINE 11trt4!!_w IIC' / f�Yl
1RFAltiIfA WRV :SIA �
IXn2LVN�Ai iNn.�l'F h' V I.1 ._J.I
InJi��iJuaL� anJ marrinl coupks are limiied io onc hnmtueaJ uandaN dcduc�ion. As �he �eceip� ni Nis Jeduc�an httomes
morc beneficiaL therc i. more mcrntnx than e�er (or homestead framl. IlomsuaJ frawl cau�a highrr ta� bills for all: thercfore.
HEA I.i3-3009 «quirzs u�pa.ers who rcecive Ihc hanestcaJ <undard deJuaion m.erily that �h<y yc eliciNe to mcene �he
brn<fi� anJ to p�w'iJ<:WAitio(ul iJemi(yim_ intarmniun �ecesr�n� iu allw� count�' go�rmmem �o beiter mini�w Iromccica�i
filinfp.'lliis inlnrnwinn xill M Ae(u rnnftienli�l nnA r.m nnly h. atettuJ by amhnriinl rounty nlliainls. ILe Depanmrn� of
Local Gorcmmrn� fi�unce ��ill usc �his infortnation N crcatc rools iha� �vill h:lp cvunry uf5cials climinatc homcsttad frauJ.
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Ta�pa��er Name Prnpertc Address
Dickison, Burthel / II Jackie
63a G Statc
Princc�on IN i7670
Burthel II/ Jackie Dickison II
__ 634.EState__. _._ _ _ _ . _—_ _._—_ -State�Parcel,YumAer----�Leeal-Descriotion .—
Princeton IN 47670-1910
I I II I'I I 1III1 III1I ' III I 1'I I' I' ' I /, 26-12-07-204-003.225-028 019-03225-00 NS LOT 1 PT R2
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Owna I First Rfiddlc Lut
h f"�1 � i G�-' � 5 0•J �
��'Addr�.v (uwnhr end imxY: ciry: itatc: end ZIP c�:.: j - �-" t�S�mc as p:cyem nddress --- �' ' -
(e 3 y E�}5 r s,�qr-z 5 �i f Q;,�, c�-j�.� �� _
Social $ecurity Number flast 5 digiu) Drivds License/Sia�< IU hmnber Qast 5 diviL•) Othcr (plcac specify in Part 4 below)
// $04
S�au;c First Middlc Last
J1jG%i FG.a�..� �iGI<< 5o`J
Mailine Addrcss (�umbcr and slrcc4 �ry', siatc, anJ "LIP co�k) �'S:une ai p`oprny addra>
Social Stturin• Number (lazt 5 digiLS) Dmrrs Limnse/State ID Number (la;� 5 digits) Other (please specify in Patt 4 bclow�)
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Each undersiened certifies, under penalty of pequry•, that the abo��e and foregoing infortnation is truz and cortect and that he or she is elieible to
receive the homestead standard deduction on this property. Each undersigned al;o underslands that, by claiming additional homestead deductions
unlawfully, he or she may be liable for back taYes and substantial financial penalties.
Owner I Si�mnpve fYutc l�elephonc
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N� PR.- O i C � G iJ.[E .