HomeMy WebLinkAboutHomestead_Dougan (5)e��`n � CLAIM FOR HOMESTEAD PROPERTY TAX
�de� CREDIT/STANDARD DEDUCTION
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,-�w.. � State Porm 5473 (R2 / 5-92)
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INSTRUCT/ONS: See �everse side lor liling insfructions.
FORM
HC10
YEAR
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i �we� /r�A"� y�. -UouGAn� ANK '�+�6�e�`yfit`n'at on ihe 1si day of March, 79��
�occupied as our principal place of residence ihe fol�owing described real property to,r% w��hi�ch�a�HotmLestead Property Tax Credit is hereby claimed:
We) awned ❑ Are buying under contrect . ��x� N' r�1.r�J�,�
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❑ Have a beneticial interest in the entity that is liable for the property taues on the property and t wns e property or is buying under a contract.
' CONTRACT RECORDEq ' � �
If bryinq on convacC Fee Simple ownels name . . .
Recorder'S office where contracl is retorded Rewrd number Page
Counry /
�si/3so,�/
" PROPERTY DESCRIPTION
Township . . - Ta<irg dis[rict �
Iowq township) /
iNCCToN
Parcel number Q "� O legal description
bl9- e�-ao .�� AD� �/ 5 P�
It any portion ot the residential strucmre or the IarM not exceetling one (1) acre that immetliatety wrrounds that struaure is used to produce income, descnbe ihe use and portion
ot the property utilized to protluce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Caunty / Township County
�1/ BS.�.I
reby certify the above statements are irue, correct and complete. Signamre ot c�aimant
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arMstreet. dry. siare. zlPCOde) �
B�a �i 7 6 ��N�u��i F
ASSESSOR USE ONLY TRUE TAX �� ASSESSED MOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately
surrounding residential improvemenis. (�)
Other land (p�
Total land (line 1 plus line 2� (3)
Dwelling (4)
Residential improvements .
Garage � (g)
Other improvemenis (6)
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line � (g)
I hereby certify the above is Irue, CorreCt, and Signamre of Assessor Date signed
complete.
�rying action - Synature o( Autlitor Date signed
19_Payt9_
Lesser of 1/2 Homesiead
valuation or 52.000
STANDARD DEDUCTION ALLOWANCE
S
Date signed
Gibson County Audilor
101 N Main
PRINCETON IN 47670
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2308
Mary M Dougan
1120 N Main St
Princeton IN 47670-8664
�liR FORM �)KIF:I HMI
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IU9RI�ZBY ill! DE�ARMEYiUF Lq:LL Ci(Y�'cLYMfAT fY:A�[E MLI.�"al
IndividuaL� and marriN touplo are limi�ed io orc homc9caJ uandaN dNu.iioa As the rtceip� of �his dedurCwn becmm '
more beneficial, thrre is more incen:ne than ecer (or honxsteal GauJ. Ilomo�uxl :mud causs h�her tu hills Iw all: thrreiore.
HEA lii-0-3009 requime u�paycn xho rrcei.e Ihe hanestcad <i�ndvJ ANuction m crrity tha� ehe} � eliciblc to maei�e �hr
benefi� ami ro pnn'idr a�klitio�l idemfirinc infurtn:rtiun nemsan� io allw� cwnp� gmrmment ro betmr muni�w homrnead
filin��_ This in(orrtutinn x�ill M1r Aery mnliCeNial anA can only M� arcttseJ by amMri>eJ rnunty n(liciuls. The IX�wtnnrent of
�i��i��ni�i��n�ni���ui�i��n��in��in�ii�i��i���ni��ni�
Tasoaver Name
Dougan, Mary M Trust
State Parcel Number
�26-12-06-302-003.833-028
Prnpern• Address
11?0 N �fain S�
Princeton IN 47670
Leeal Description ~ Y
01&03833-00 SWALLOWFIELD LOT 1
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OH'ner I First Middle Last
ARy M DO uc,A rJ
� s�nddr.—..0 (r�unbcr ar,d'o7Si, C12�. S:IIt:, Ofitl ZIP <04Cj �/ 5=me as prop:m address
%y
Social
Spou;e First Middlc Lvst
Mailinc Addrzss (�umber and strce4 ���y. smie, unJ "LIP cuJe) � S:une u pmpeny address
Social Stturiry Yumbcr (laz� 5 digi�s) DrivcYs Liccrtcc/Sta[e ID Niunbcr (lut 5 digits) Othcr (plc�sc spccifi� in Pan 4 bclow�)
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Each undersitmed certifies, under penalry of perjury, that the abo�•e and foregoing infunnation is we and correct and that he or she is eligible to
receive �he homes�ead standard deduc�ion on this property. @ach undersi¢ned al;o undersmnds that, by claiming additional homestead deductions
unlawfully, he or she may be liable for back taxes and substantial financial penalties.
Oun<r 1 SisnaWre Uam l'elephone
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Spouse Si re ��c Tclephone
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