Homestead_Dill (6)� � CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� State Fwm 5473 (R614-03)
Prescribed by ihe Department W Local Govemment Finance
See revcrsc sidc loililing
�
y�a� FORM
HC10
YEAR
I(We) ��/" ���1 certify �hat(o�n the 1st da of March, 20
I(We) occupi as our principal place of res ence lhe following d cribed real property for which a Homestead PropeRry Tat�C2d��reby daimed:
❑ I(We) owned ❑ fve buying under contracl //�� Q
' Have a benefidal in[erest in the entlty ihat is liable for the pmperty taxes on the property and that owns tNe propertyor��s buyirig under�conVaU.
It 6yvig on coniraq, Fee Simple ownefs name
Remrdefs office where conUacl is recorded
Tamship
Legal
N any pwlion ol l�e residenilal sW cW re w the land not
ot the praparty utiized b produce inmme.
Rewrd number � Pa9e
Tacing tlistrict (ciry,
���� r���% �BJaI DropeM ❑ Mobile Homo (I.C. 67.1-�
) aue ihat immediatety wrrou ds Nat s re is used to produce income, describe the use antl pwtbn
20_Pay20_
Lesser of 1/2 Homestead
valuauon w E3i000
S
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
2953
SIaIE f00.4 �!KIM_ I W°I
1RFASLRE0.f00.411.�
InJiciduaL. anJ marrieJ coupla are Iimiied to nrc hnme�eaJ �tandaN JeUunion. As �he �eccipi of ihis deduoion beconms
more bcneficial, therc is morc incen[nr Nan e�er (ur homo'rcad (rdud Ilomn�ead Baud causs higher ta� bills tor all; therefore.
HEA liia-'_IX19 rcquime u�pa�en x�ho reccive the hanesread st�ndaN Jnluction m veri(y thai they art cliciMe w mcene the
beneni anl io pnr'idr ahtitiunal iJcntii�'inc in(wmanon rKm'vn' io allua cwnn� grnrmmeni to b:nrr miniror fwmesttaJ
filin�-. Ihis in(amuiion will M AciM tnnlidenlinl mxi een nnly M arcnud br amMrizd rounty n(Teials.'Ihr Ikrannrem of
LUC]I GOYflMIfO� FINMC \\III LLK 1�115 �(I�OR11ibOf1 N CIGtIC hVI� II411 \\'III M1CIP �wnn' uffitiaLs climinam humc>tcad fiaud.
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T•rxpa��erName Prnpert��Address
Dill, Leonard A/ Phyllis Ann
Leonard A& Phyllis A Dill
717 S Hart ST
PRINCETON IN 47670-2641
�i�n��ni����n�n����u�u������ni�u�ui��ni���in���i���
'L.£d/j/f��Gi� l%r
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'— ig Addn,v (nuuioer mu iti�[: ciry,-sam, and Z{P coLc)� - - �
7 / 7 � % �' ,�le
Social $
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717 S Ilan
Princeton IN 47670
State Parcel Number Leeal Descriotion
X 26-12-07-304-002.440-028 019-o24ao-oo HALLS 2ND 27 PT
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�h�//.�s n,`l� �1
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Aadine Address (t�umber and 51tec4 ciq'. �Wlc, xnd LIP caie) �� Q
7 % -s' f��'T �/
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ntiam�
_ �.n_Snmcn<propem.addres " _
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Other (please specify in Pan 4
�190- o o-c
� S:mie :u pmpeny add�
Othcr (plcasc spcciF in Pan <
undersigned certifies, under penalry of �rjury, that the above and foregoing information is tme and corrzct and that he or she is elieible to
;e the homesiead standard deduction on this property. Each undersigned al;o unders�ands that, by claiming additional homestead deductions
✓fully, he or she may be liable for back taxes and substantial financial penalties.
xna I $ienzWre
J�'✓'-4/ i ..
POII.iC SiptaNlC
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