Homestead_Dillon (5)rt, CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
/ SIa1e Fwm 547a (RB / {.03)
Presrnbed by the Department ol Local Govemment Finance
INSTRUCTIONS: See reverse side Iorliling insinictions.
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FORM
HC10
YEA
y�
��e) certify lhat on 1 st day o( March, 20_
I(We) occupied a r principal place of residence ihe (ollowing�ribed real property for which omestead PropeAy ac Credit is hereby daimed:
❑ I(We) owne ❑ Me buying under contract � �,(�.rnm,o.
� Have a benefidal interest in fhe entlry that is Iiable for fhe property taxes on the property and ttiat owns lhe property or is buying under a conVact.
I( buying on conVaq, Fee Simple ownefs name
Recwdefs ofice where mniracl is recorded
Counry
Tamship
i11�-Va��J-c.{J I CX.LlJ�.c�n
if any ponion of Ne resiCenllal sWCture w the Wnd not axceeding one
ot the property utilizeC to produce income. �
To.vnship
I hereby certify ihe above statements are W e, conect and complete.
(number and sfieet ciry, sfafe, ZIP code)
Record number
Tating Aistrictlntj;f��townshiP)
Is Ne property in
Page
O I M%'�eai p�onero U r.waie Ha„o (i.c. �r. �-�
it imme iately unounds Nat sWGUre is used b pmduce inmme, desc+ibe Ne use and poNOn
County
of claimant
TO.vnShip
._.. ��" 5'a�j �'�i%�' � ��v➢R.Y..�"C c�S�^ x`^' �{j` �:. T `" "` y y-�, . . . y � . _Y . �
`r�'�� �y M �.�,y� � v;� ,TRUE�TAX � ASSESSED VALUE 'aHOMESTEAD tNON4tESiDENTIAL�����
i_ ; :�,ia`,d;d,•."EC'AS5,85?E.4�SO�ReU �i�N.IY?s2��-t�"_',�,.$.;E'4 �.,``�i�,�VALUEq`.a_-�-� �AT4100% OF�T7V� �r,.� VALUEt�.� ��_,j,�T r2'�°3'•."VALUE �.�z�:��.�
Land not exceeding 1(one) aae immediatety � e,����..it�T�,^*"���°--�_�x�-��
suvounding residen6al improvements. � � �•,,,� °^g�S °° Y� -�_ ? y°'
rL 1'�.ir��� '�?i�F�.
Otherland ��`�i��� ��F'' ` �
�z� � r�`�'.'� �
Tdal land (line 7 pfus line 2) (3�
� .�,'3s.�' ��y+"`� �-�r`��'•3
Dwelling (4) c}�',,,�*',�,�':�%uX`r`� ���
Residentiel improvements or Mnualty s„;�F+ a s w� t
Assessed Modle / Manufaclured Hane Garage (5) �M, �x���^' �'T�� '��''^�" { ;
_ ���s ���
G:` .K�:'?'?�;S,.v ;`,i :,*j
Other improvemenls (6) ��;��j .;',�' `.. � �
� ,; �:'.�i�+'.�.;i1�'s.=
Tdal improvements (line 4 through line 6) (��
T�tal value (line 3 plis line n (g�
1 hereby certi(y fhe above is We, corred, and Signature of Assessor oate signed
comptete.
Vaifying adion - Signature oflwdibr Date signed
'�.=>�'.4�`�'u.'�..'�=�3�3`.:c�i`=e°ti�1"�x'�.�'.�.�,'��'.4'�"45TANDARD:DE�UCTIONALLOWANCE `�i'.s�"'.',`�r..a2�i:'<:±a.°'�5.-�}"'�z:�+:�"���,�t'����5-�
. . . . Y.��!sYte
20 _ Pay 20 _
Lesser of 12 Homestead S
WueLMI Of 535.000
Sgnature of Auditw � Date signed
Gibson County Auditor
107 N. Main Sireet
Princetan, IN 47670
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Cidl[ lILlN ;:f W �R:N-N� IR:ACpp,�p IUkN IS:.S
InJi.�iduals and muricrl couola are limi�nl �o one hunrs:eaJ siarxLnl Jnluniun. d. ihe receip� of :his Jnluaiun 6acame�
mom MncficiaL �Iwre is more frcrn�i�c tlun crtt lirt homcsn�d GauJ. Numo�cad Gaud c�v.cs hiehcr ea� bill: (or.lh tlxrrfom.
IIf;A IiJ4 ?0119 rtyuirz tacpa�en xSo nc:ice tht homruead .tanJartl dedunion io ceri(y �hai �hel' are elieible to �ecei�c ihe
banctii and �o prm'idc aiMiinmal idcnuP�im_ ir,�i�rmmi�m nc:csvn� io a14M� muntr ¢mxmmcm to bata mmimr homc�ead
filir.p.. Th� in(omution xill br krp confidrniial and can only Ar attr.>ed b.� amhonzeJ coumy ollicials. The Departmem o(
— Taxpayer Name Location Address
Dillon, Joshua E/Ladonna J
� 413 S Seminary
Princetan IN 47670
3136
Joshua E Dillon I II�I�III��III �II I II�II� II II�II�IIII��II�II�II�I�II�II III�II��
413 S Seminary
PRINCETON IN 47670-2431
��Ih�i�Plr�u�h�l�illly�"nulli���illy���uu�IIl�Pih�i
FILEI�
MAY 10 2012
State Parcel Number Leqal Description
26-12-07-403-002.833-028 CLARKSVILLE 27 PT
�II I� II
c.�.M�
� OUNT AUDITOR
This form �q`�'be re�urned to County Auditor's office. °
Please do NOT send this form back with your tax payment to the c_ounty treasurer.
� C��'l l�U � �r f1�S�
�lddrtss (numbcr and strcct, cit�t sta:c, and "LIP codc)
� � �. �t'_lYl � (1Gru_
Sccurig- Numbrr Qast i digiis) Dnvds (.ittnu/SUtc ID ?lu (Iv: 5 diei's)
Addrsi (�cmter tnd s:rcei. city, state, and "J.IP codc)
5 digis)
�; I 10 ►-�
� Same as propcny add-ess
Other (Plrnse specify ir. Pan 4 belvw)
Sux
l ; � ;.
�amc as pmpem add:ess
Other (Plcasc sptr.fy ir. Pan 4 below)
StlN
undeniened ceni6es, under penalty of perjury, that t6e abo.�e and foreEOing infortnation is true and correct and that he or she is eligible to
re �he homestead standard deduction on this property. Each undersiened also understands lhal, by clzimine additional homestead deductions
rfully, he or she map be Iiable for bacA ta�ces and substamial financial penalties.
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