Homestead_Quinn a
SIAM ton' s".RU tart TREASURER FORM:DMA
Arrw.m BY'TnTE BtNPW Of 4waisr5.'an ruscuBrn BY ME DEEARTW'NT OF LOCAL C oVEt4MENT FINANCE r..I.1-'_4I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead raandanl deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than e'er for homestead fraud.Itotne-stead fraud causes higher tax bills for all;therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verity riot they are eligible to recehe the
benefit and to provide additional identifying information necessary to allow roomy glneminent to better monitor homestead
filings.This information will he kepi conlimlentinl and can only he accessed by authnrired county officials.The Department of
Local Govermnent Finance will use this information to create tools that will help county officials eliminate homestead fraud.
• PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Quinn, Jillian K
71 I S Stormont
Princeton IN 47670
3171
Jillian K Quinn
711 S Stormont State Parcel Number Leoal Description
PRINCETON IN 47670-2730
26-12-07-404-001.803-028 019-01803-00 KOLBS ADD
IllllllttrlElllllrtlIII i IlllllttllElt IIIIIIIIIIIII
PART 2:TAXPAYER INFORMATION
Owner 1/ First Middle Last‘ . i11\ Gn (-r1S vl2 wino
•Oa,Address(number and snag,city,state:and ZIP code). -.— - — - -- — __ am.-Same ac pmpem address___
11 I 5 S r monk ?c'tnce.W tJ x-11 Lcoo-1()
-
Spouse First Middle Last
Mailing Address(Number and street,city.state,and ZIP code) 0 Same as properly address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
Sta.v
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury.that the above and foregoing information is true and correct and that he or she is elieible 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 for back taxes and substantial financial penalties.
Owner I Signature Date '
0
4 rt�� CLAIM FOR HOMESTEAD PROPERTY TAX
- � CREDIT/STANDARD DEDUCTION
'� •. ) Slate Form 5473 (RS / 10-01)
Prescribed by Ihe Depariment oF Local Govemment Finance
INSTRUCTIONS: See reverse side lor filing instructions.
I (we) � � J
I(We) occ i as our principal place of residence the follovnng desuibed real
FORM I'n YEAR
�HC10 1� `
� �
day of March, 20_
:dil is hereby daimed:
❑ I(We) owned ❑ Are buying under contract --""' `^''�� � un I
�iave a benefidal inierest in the entlry that is liable for the pmperty tazes on lhe pmperry and that owns the property or is buying under a conVact.
c >':a�:.f?s??L�'r�R;'�+__""`.'y'..�$j�r � t� �-�..x,.""��.h:.�'�,'�nrS�gCONTRACT.'RECORDED'',_'v� � .si .j�;.;tiF,.�'� r,_ .:.ib. ^ -
If buying on contract. Fee Sunple owners name
Remrders olfice where conUaq is recorded Record number Page
Counry
Tamship
�ce�n�r O' e D�^� ( Le9al de:
V
it any portion oi Ihe residentlal 5W ctura w Ihe land not
of the proDerty ulilized to produce inwme.
Taing dislrid (ciry, town, fownship)
� 1 I Is Ue ProPeM in 9u on:
eal properry ❑ MoOile Hwno (I.C. 61.7-7)
one (1) aae t�al immediatety surrounds that sWCture is used to D��uce income, desuibe the use and portion
"�"����'i'"��-F�`` �'•aZ+ v-�.+�E'g``�` i$'TRUETAX�it-'�. ASSESSEDVALUE � HOMESTEAD ,g(� NON-RESIDENTIAL§`��"� _
� h?=�'���ASSESSOR USE ONLY� T 4"`� �'N �" �.} �
:Z��.'.�±Yiv �.'2�'iS��'... .!�: ��ls,.4�� �ta,.VALUE,;,s c.. � ATi100%.OF'TTV{i .%�ss VALUE�'� �:"v... *ta+`.F�VALU�.z:r, �.k`t'_
Land not exceeding i(one) acre immediately 41 �.,�r{��-;�'*� �'�•^.. �� ;� r's -:
surrounding residentlal improvements. (� � " x;��;�'-�` :r; � y;>��,�-'
•�j`a4"Y?^�...j�,_ � _
Other land --''�"�"''!•'�'
(z) fz::<v=��--;�r �
�E.... `�;.
-.°a,�:,<_,A.:,_: _ ��
Tdal land (line 1 plus line 2) (3�
Dwellin 4 7 ' �.{'L'-Y�``'i€?-?�'`�atry3
9 () .� � r�+''� r% ry'e a`'
Residential improvemenLS 't `"" � �`°� � �� �h��u;
�' ;L�` � 'S��"`r ....
Garage (5� "� �r�'�,��'� �` �Y `:
J�.`-:..:: , ..,r_�.".y- n'.SsG,_�l:
. . .1.. ... 33k
Otherim rovements =-"'�"��'��`�j`"`=
D (6) . �.y�;_'F;��=ir
Total improvemenis Qine 4 fhrough line 6) (7� �
7Ual value (line 3 phs line n (g�
I hereby ceAify the above is Vue, covecl, and Signamre otnsseswr oate signed
complete.
Verifyirg action - Signature oflwditor Date sgned
w-�'��'s�",L��i:r.c�l3��lsf."i,��� i'�e,'n'":�.`�--STANDARD:DEDUCTION�ALLOWANCE'�:u's:�reo.`�?-�i`�+:,.�'^'-a.t.'`'=.'s� rz'--:-'"�.t..._2-`�=��iiS'.3u Y2e.:+;
20 _ Pay 20 _
Lesser of tl2 Homestead
Valualion or 56,000 5
SgnaWw of Puditor Date signetl
�-a -oa,