Homestead_Dillon (6)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
` Slate Fortn 5473 (R8l 7-07)
� Prescnbed by Ure Departmeirt of Local Govemment Finance
INSTRUCTIONS: See reverse side /a fiiing insLvc6ons.
YEAR
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� �'`'e� ce�tEO�itb�' i�T��i�'}�' arcn". zo_
I(We) occup' as our prinapal piace of residence the fdbwing descnbed real property for which a Hwnestead Property Tac Credit is hereby daimed:
�I(We) owned ❑ Are buying under mntraU
Have a benefidal interest in the entity Nat is IiaWe fa the property faues on the property and that owns Me property or is buying under a contrect.
If Wying om m�fraq, Fee Simple ownefs nartre
cmtraa is recwdea
Counry
Tacv� �{ n�ct (�cit�y, t�own.
OZHQ / H/�
RecarC number I Page
Parcel numbu I Le�al tlescriplion %� P T � � Is Ne property in quesGon:
- �f iQ
❑ Real property ❑ Mobile Home (IC G1 7-n
If arty pMion of the resitleMial sWdure a Na WM not exceeding one (1) acre Ihat immetliately surtounds Ihal sUUCture is used in produce ineoma. descnbe the use and portion
aFihe property WGied b produce inmme.
-/a-i8-�oa-�oa. �9? -v�8
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Land not exceeding 1(orre) aae immediatety - x a y:t x ;: �t'; �".
surtoundirgresidentialimprovemenis. ��� _ .$..;--2;.�;.'� �
Oiherland �p) �.?•:�t si:�:-,
4if y . i
Tdal WrM (line 1 plus frne 2) �g�
r a . ..�
ReadentialvnprovementsaMnualy �Ilirg (4) ��:' r�' 7 �.. � +;:-:�:
Assessed MoWle / Manukch�red Home ��..-_°o::�-�;:: -;-
Ga2ge (g� - � �: C. .,� _: . ...
Otherimprovements (6) � .,,.
Tdal imprwements (lina 4 thiough tine 6) (��
TUaI value (line 3 pl's L'ne n (g)
I hereby certify Ue ebove is true, corrett, and Signature ofAssessar Date signed (monlh, eay. year�
complete.
Vailyirp action - SigraWre W Audilw Dale signed (month, day, yea^
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�— PaY 20 — 45.000 for 2007 pay 2008 42.000 tor 2010 pay 207 7
lesser M 12 qq,000 for 2008 pay 2009 47,000 for 2071 pay 2012
Homestead Valuafion S
w 43,000 for 2009 pay 2070 40.000 payable afler 2072
SignaWre oflwdNw Date si9ned (month, day. yea�
STATE FOR\19569 (Nl&10) iREASURER FOR.\1 TS�IA
MPRO\'ED BY SfATE 90AAD OF ACCOI/�TS, 2009 PRFSCRIBFD BY THE DEP,IRTIE\T OF LOCAL fAVER.\��\T FI\A�CE IC61:1-'_'-A.I
, / � ' / / / . ' 1 � r 1 � , �
Individuals and married couples are limited to one homestead standard deductioa As the receipt of this
�iuction becomes more beneficial, there is more iucentive than ever for homestead fraud. Homestead fraud
causes higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
standard deduction to verify that thcy are eligible to receive the benefit and to provide additional identifying
informatiou necessary to allow county government to better monitor homestead filings. This information
�r�ill be kept confidential and can only be accessed by authorized county officials. The Department of Local
Covernment Einance will use this information to create tools that will help county offcials eliminate
homestead fraud.
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T�ma.erName ProoerlvAddrese $tnteParcelNumber �.eealDncrinlion:
Kecin Dillon 727 S FIART ST 26-12-IS-102-002.097-028 FIALIS 2ND 28PT
PRINCETON IN 47670
Comp(e�e and �eturn to: IW�iII�fl]tltlC]QdIi01LiIG111JG�iI�u:�fiif�iC�3uiiil"`iiiuu�ll�"
GIBSON COUYTY AUDITOR, 101 N MAIN PRI�CETOI� IN a7670
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Sotial Secunry NianCer (last 5 Elgits) DmeYS LicroselSUte ID NwnEer (Ias15 digib) stxe . pN¢r �p�ease soedry in Part 4 E¢Imv)
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Spouse ' " � ' Fvsf " � MiCdle + Last
�ac���e� S�e Q��'�oi
Mailvg AECreu (nsnper aM sbaet. tiry. state arW ZIP cotla)
� Sama es poparty adtrasa
SotialSecuriry NumDer �last 5 tllglb) Drivefs Licanae/State ID NumDer (kst 5 diglb) ='�° , �Ne� (Weasa spacily in Par� a h¢IO«�
4. _ _ S
Each underoigned certifies, under penalry of perjury, that the above and foregoing information is true and correU and that he or she is eligible to receive the
homestead standard deduction on this property. Each undersigned also understands that, by claiming additional homestead deductions unlawfully, he or
she may be liable (or 6ack taxes and substantial financial penalties.
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GIBSON COUN7Y AUDITOR