Homestead_DehosseCLAIM FOR HOMESTEAD PROPERTY TAX FoRwl
CREDIT /STANDARD DEDUCTION Hcto
State Fenn 5473 (R71 5gM
Prescribed by the Departamd of Local Gamffwrwd Fahaue
INSTRUCTIONS: Sea reverse side W Ming instructions.
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Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the pmM�pejW?dfif?8Va
'-:",CONTRACT.RECORDED�"����"l*
ff buying an ..h Fee Single, owner's name
Rmorder's d5m where cm*ad m racmded Immd number Page
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• .3 3 7 A L Ls the property question:
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If portion of the rasderdial stnxbae w iris lad not exceeding ate (l)
eve that imraffJely mmmirdaftl
a used to We&— axxxne. describe the uma and portion
of utitzed hD proox* irlmll�.
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ASSESSED VALUE
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Township
I hereby certify the above slaternents are true, correct and oorn*ln-
(number and afro city, statik ZIP cads 1 T]
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ASSESSED VALUE
Lesser of 12 Hornestead
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Land not exmechng 1 (one) acre irrynedately
surrounding residential
Other land
(2)
0
Tctal land (Ike 1 plus hue 2)
(3)
Dwe0ing
(4)
Residential irnprovements or Annually
Assessed Mobde I Manufactured Home
Garage
(5)
rgg
Other anprovenaents
(6)
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Tdal brhproverrerhls (&* 4 dmmh fine 6)
(7)
Tctal value (Ins 3 phn fine 7)
(8)
I hereby certify the above is true, correct, and
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Signaexe OfAsamiscr
Data signed
Vm" action - Sqnature af Axnar
Data signed
20_Pay2O_
Lesser of 12 Hornestead
Valuation or SWAO
s
Sq%ature of Auditer
Date Signed
` • atAlE FORM.9Mairl YNI TREASURER FOAM i}IA
MPRn'ED BY CpTE AJIM '.MYR:Ti 3vn PRf9EIDFD BY THE UEPART\IYT(i LOCAL(SWSLNMENT PNANCE K'H.I-Lit
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 mu for homestead fraud.Homestead fraud causes higher lac bills for all:therefore.
® HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county goverment to better monitor homestead
flings.this information will he Rcpt conlidemial and can only be accessed by authorized county officials.The Depanntent of
Local 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
Dehosse, Troy/Stacy
R 113ox 30-a
Patoka IN 47666
660 b.c.
Troy Dehosse
3149 N 150 W State Parcel Number Leal Description
PATOKA IN 47666-9021
It'Itlll lt'llll ltllrtt'Itll tl ttl ltrlil ll'ttl lltlrllltllal'll tl 26-04-26-200-002.384-018 010-02384-00 PT SW NE 261113.337 AC
C-1
1
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
40Ig Address(du,bcr and sum,city,state,an"a ZIP Code) ' - --- -.E me o'propcnylddr.- -- --- —— --
I4ci ,\i iSO IN Pee <a ( ii yl,Vie C
.
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 Signature Date
PART 4:ADDITIONAL INFORMATION
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