Homestead_Dogloso Properties LLCCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD OEDUCTION
Steta Fmn 5473 (R6 / 6-03)
Presuibed by Ne Department N Local Gwemment Finance
INSTRUCTiONS: See ieverse side loi (lirg instnxtions.
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FORM YEAR _
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� �e) � . . certi 'lfiaY'olfth�l�i-day of March. 20
I(We) occupied as our principal place of residence Ihe following des ed real property for which a Hort�g t�,���kLClFOreby daimed:
❑ I(We) owned ❑ Me buying under contrect (31dd6N Efi�llNfiY A`1JBIi6�
� Have a benefidal interest in lhe entity that is liable for the property taxes on the property and Nat owns the properry or is buying under a conUacl.
I( buying on conirad, Fee Simple ownefs name
Reardels olfice whaz�conirad is
Tamship
7ating distrytl�(ciry, toxn,
Parcel n 6er Le9al descriptbn Is the pm rty' ueSUOn:
� D �Q �' � �Real D�operry ❑ Mobile Homo (I.C. &f.7-� .
If any porllon of ihe resitlentlal aW cWre w Ne lantl not exceeding one (1) aae ihat immetliatey wrtounds Ihat re La used b proeuce incwne, describe the use and panbn
of ihe properry ulil¢etl b produce i�ome.
,21v_ /,t-o7-3o.t-ODj.o'-lD-oa8
County
County
I hereby certiy the above statements are W e, corred and complete.
(number errd sfieef, city, s(ate, ZIP coda)
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��''}�a�."``„�,_'�i£'��T,*„}�K'�,�,'�':�°�t��,k?'..e'ay�.,�Ssc'1��''-iSTANDARD:DEDUCTION'ALLOW/WCE� �''T:% a''' a' t'
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20 _ Pay 20 _
Lesser of 1i2 Homestead
vaivauon or 535.000
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Sgnahire o(AUdita ' Date signed
• cTitElORtl �lW IM_ /!'.M� TRFASUIFA f0A4 ..ilA
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
LidiciduaL anJ nnrriN ooupb are limittd to one homeeteaJ �anAaN deUunion. .4� Ihe raript o1 this dedunion beconm
merc beneficial, therc is morc incentnr than ecer for homeiteael frauJ. I Iome.�eaJ f�aud c�uses hi�M u� bills for all: thertforr.
HE.\ 13a3-?(N19 requim uapacers who rcei.e ihc hanestead s�amtarJ �kvluctian m.eri(y ilw� �he�� aa eliciNe io recene ihe
benefi� anJ �o pnn'id< a�kliiio�ul idenuirim_ infumu�nun necr.vn� tu allw� counrc Fm'emmrnt eo Ntter munitw IwmeurW
tiling..'Ihix inlurmuion x�ill M Acry mntidentinl mA can onk Me accrc.cA hy w�MrireJ vouny� ofTaiul.. The Ikpannxm o(
Lucal Guvemmcm fi�um�c xill u.c this iniormation W v'rca¢ cwis iha� will h:lp cowm� ufficial. dimfnmc lwmcxrcad frnuJ.
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Tasoaver Name Prnpertc Address
Dogloso Properties LLC � I � W`����, -y� ,
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2869
Dogloso Properties LLC
clo Ganet Schnelby
PO Box 70
PRINCETON IN 47670-0070
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State Parcel Number Leeal Description
k 26-12-07-302-003.040.028 01s-o3oaaoo OLD P�qri 20PT
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Oxner I First Middl< Las�
G���; � S'�N,���y
-- igAdLr�v(nwulermiusu-i�.eLCt:j.�m:c.:.n3Z:Pcw:i _ _' ._ . .— _ .. .u_c�m%�pm�.�.oddrec; _ __
1�C� i3oX 7C7
Social $ccuril} Numbe� (6st 5 diciLS) Ihivefs Lfcta�c/$tate ID Nmnber (laz� 5 divits) Oihcr (pleu< spccify in Pan d below')
S�wuu First Middle �
Mailine Add�ecs (Numbcr and st•tt4 d�y, siaic, and ZIY cale) � S:une:s pmpem add`as .
Social Sccurin� Numbcr (laz� 5 dici�s) Drivcrs LicensNSutc ID Numbcr Qact 5 digils) Ochcr (plcsc spcci(y in Part 4 bclow)
svrc
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Each undersii.med certifies, under penalry of pequry, that the above and foregoing infonnatiun is we and corrtct and that he or she is elieible to
receive the homes�ead standard deduciion on this property. Each undersigned al;o understands that, by claiming additional homestead deductions
unlawfully, he or she may be liable for back taxes and substanrial financial penalties.
Ooircr I $i:n c Dete 1'elephonc ��
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S�rou�c Sipwmrc Date Tdephonc
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