HomeMy WebLinkAboutHomestead_Dixon (3)CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION •
` � • Shate Form 5473 (RS / 1P01 � - '� �
��a Presaibed by Ue Depariment of Local Govemment Finance
INSTRUCTIONS: See 2verse side /or �ling inshucfions.
FORM
HC10
YEAR
�(�^/e) c�rtiry u,at oo me tsi�-�da'y;of��i, 20_
I(We) occupi as our principal ptace of residence the (ollowing descnbed real property for which a Homestead Property T�c Credit is hereby daimed:
❑ I(We) owned ❑ Are buying under wntracl J U L 14 2003 �
�Have a benefidal interesl in the entity that is liable (or the property taxes on Ihe property and fhat own/ e property � is �uying un �r a�ntraG.
" �vIL.1�;Lc.�.J!s _'i
I( buyim� on tanVaq, Fee Simple ownefs name
Recordefs ofica whme contraq is recorded
Counry 7avnship
Par number Lega10 scri0tio !
� �
H any po ' a( Me resiEenllal atnicNre w Me land nd axceNinp one
of the properiy utif¢ed t0 produce income.
County
Twrnship
1 hereby certify the above statements are we, corred and complete.
�dress(numberaM�t, ' ,�fate ) �/J ,�
ill�/D � t% ��
Ta�ing district (riN.
^ , Is ihe Pml
Kl
�hel immedately wrrounds Ihat
County
e
0
Record number � Page
iquesUon:
Real prapery ❑ Mobile Homo (I.C. &1.7-n .
�re i5 used N produte (ncane, desaiba the use and portbn
Township
20_Pay20_
Lesser o( 72 Homestead
Valuatlon or 56.000
3
SignaWre of Aud Q� �� / 0� ��I� , �/ I uat�nyq J/,/�
� l �i.�� 1 �� 7
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
1109
[liR i00.M ��YwIM_/"rvl
iRlASUIIERfORN'SIA '
IndiviJuals and mr,rinl mupltt are IimiiM �o oce homeuca0 �tandanl dNunion. As the recttip� oi �his daluctan become�
more beneficial. therc i> morc Incentrce than e�er for home..ma�l frauJ. Ilomo�ead fiaud causes hi�her ta� bfll> for all: therefore.
HEA Gti-1IXl9 requim uapa.ers v:ho receire Ihe Irwnes�eaJ standard �+iuc�ion �o verify thai �hey are elieiNe b mcenr �he
Mnefit ani to pmeide addiGOnal idennirfne fnformatiun nem'vn� ro allow counn� @m'emmem �o Nnzr monfmr homesrcad
tiling,a. Thic in(omuiion will 6e Aep mnticentinl anJ can nnly be accessed h�� amMrizeJ rounn� otFciak. The Ikpanmem of
Local Gmcmm<m Pimnee x�ill u+< this informanon to trcatt twls tha� aill heln rountt� official> diminam homestead fraud.
Robert R Dixon
1710 Petersburg Rd
PRINCETON IN 47670-8302
�i�u��n��i��u�in���u��n�n������nui�i�n��n���n�n��
Taxpa�•er Name � Prupertc Address
Dixon, RobeR R J 7!O �r fY,s�,.,-��
.iZtaorY�–
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State Parcel NumAer Le�al Descriotion
�( 26-12-06-104-003.835-028 019-03835-00 SWALLOWFIELD LOT 4
�' 1
Owce First Middle n Lu�
o�j/12� � ui o �
ig Addre.v (number and strec�, n . state, and LIP codej . . --- - — - -- - ' '�Sarx:ti pmpzrt� ad�.xu-- -- – --- –
//3� /,/ /�i��y sf
Social
�
Spoa;e First Middlc Last
MailSm� Address (Number and stree4 ci1y, sWle, end ZIP caie) � Same ati pmprm addrts.'.
Sociai Sccurin� Numbcr (las[ 5 dieits) Drivcrs Liccnsc/Statc ID Numbcr (last 5 digi�s) O�hcr (picssc specify in Part 4 bclow�)
sm�
� . � �
Each undersigned certifies, under penalty of perjury, that the abo��e and foregoing inPormation is we and correct and that he or she is elieible ro
receive the homes�ead standard deduction on this property. Each undersigned al;o undentands that, by claiming additional homestead deductions
unla y, he or she may be liable for back taYes and substantial financial penalties.
Ow r I i n � Date Telephone
Yll� !o � �� �
Spouse Siputure Uatc Tclephonc
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