Homestead_DawsonCLAIM FOR HOMESTEAD PROPERTY TAX
a/a 4e - -
CREDIT /STANDARD DEDUCTION.
State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side for tiling instructions.
CERTIFICATION STATEM
FORM YEAR
HC10 /49/
as
(We) - certify that on the 1st day of March , 19 9/
I (We) occupie as our principal place of residence the following described real property for which a Homestead
Property Tax Credit is hereby claimed: . F , I (We) owned ❑ Are buying under contract
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
El property or is buying it under a contract.
CONTRACT RECORDED
If buying on contract. Fee Simple Owner's Name
MAY U 8 lo- 1
J . I
Recorder's office where contract is recorded
Ytpcord N ffbe •
Page
AUDI I UK v
PROPERTY DESCRIPTION
County W wns Taxing District (City, town, township),
Parcel Number Legal D es Yiption
009 -OOiSo
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
PtKI Y U1NNtU b l;
Township
AN I IN U 1 KtK L:UUN I Its
County I Township
1 hereby certify the above statements are true, correct and Signa
Address (Street, number, ty, state and ZIP code) i
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Other land
Total land - line (1) plus line (2)
Residential improvements Dwelling -
Garage
Other improvements
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
(1)
1991 Pay 1992
19 —Pay 19—
Lesser of 1/2 Homestead
(2)
Lesser of 112 Homestead
Lesser of 112 Homestead
Valuation or $2,500
(3)
Valuation or $1.500
Valuation or 51,500
(4) - -
- -
Signature of Auditor
(5)
(6)
(7)
(8)
1 hereby certify the above is true,
correct, and complete
Signature of Assesor
Date Signed
Verifying Action - Signature of Auditor
Date Signed
STANDARD DEDUCTION ALLOWANCE
/
IF
1989 Pay 1990
1990 Pay 1991
1991 Pay 1992
19 —Pay 19—
Lesser of 1/2 Homestead
Lesser of 1/2 Homestead
Lesser of 112 Homestead
Lesser of 112 Homestead
Valuation or $2,500
Valuation or $2,000
Valuation or $1.500
Valuation or 51,500
Signature of Auditor
Date Signed
6
STATE FORM STN.IR:/St TREASURER FOAM 7.3-1A
.AnIMwEB BY STATE BMRDOC M[[R:ATS_!v.0 RE411®FD BY TIT DEMINIDTT OF LOCAL CFnVLNMQ,T ip:A\CE te.-I.I-L-EI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud Homestead fraud causes higher tax bills for all:therefore.
!� HEA 1344-2W9 requires taxpayers who receive the homestead standard deduction to verity that they am eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept colfideoial and can only be accessed by authorized county officials.The Department of
Weal Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Dawson, Gary A
"tr dpi
Princeton IN 47670
376 (�
Gary A Dawson 303u I► f ettrvx Il )
706 N Embrcc t / I v r ^ 1+� ��R State Parcel Number Leval Description
O 26-05-01-200-000.150-017 009-00150-00 PT N FR 1-1-10 16.50 AC
ItIuIItuIr�n�I111+ln Il'n 111ttltlnllinnllnlnrll C-1
PART 2:TAXPAYER INFORMATION
Owner 1 First Middle Last
OcuAcoen
gAddress(nt --and street,city,state,and ZIP code) —— _. __- _— _KiSmuc us property address—
-
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sne
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 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 for back taxes and substantial financial penalties.
Owner I lure Date
PART 4: ADDITIONAL INFORMATION
•