Homestead_DunkelCLAIM FOR HOMESTEAD PROPERTY TAX
CREDITISTANDARD DEDUCTION
State Form 5473 (R5110-01)
Prescribed by the Departrnent of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
FORM YEAR
I L
JUL 4 tl LUUJ
I (we) certify that on the 1st day of March, 20
1 (We) occupied as our principalpjace of residemVithe following described rty for which a Homestead P / /
Proper Tax Credit is hereby claimed:
❑ I (We) owned ❑ Are buying under contract
C,!.R--0t4
Wave a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
NTRACTz'RECORDED
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
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County
County
Township
Taxing district (city, town, township)
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Is the property in question:
Real property ❑ Mobile HMO (I.C. 6-1.1-7).
If any portion of the residential structure or the land not exceeding we (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utili7ed to prod" income.
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County I Township
County
nship
I hereby certify the above statements are true, correct and complete.
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+ umbe street, city, state, ZIP
e
Other land
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NOWRIESIDENT
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
011.
0
Other land
(2)
F N
.:1»f 11 ME
Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
1; MMIAMM
Garage
(5)
kgli
Other improvements
(6)
-S M W
Total improvements (fine 4 through line 6)
(7)
Total value (line 3 phis line 7)
(8)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Data signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION` ALLOWANCE
20 Pay 20
Lesser of 172 Homestead
Valuation or $6,000 $
V
Signature of Auditor aS _C)3_
STA i E FORM 53569(R3/S-10) TREASURER FORM TS.IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I 142.8.I
t : IMPORTANT N OTLICE TAO AOMESTEADNPROPERTY OWNEl
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
• Auction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
®
causes higher tax 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 government to better monitor homestead filings. This information
will be kept confidential and can only be accessed by authorized county officials. The Department of Local
Government Finance will use this information to create tools that will help county officials eliminate
homestead fraud.
?3" a3t PARTI: PROPER .Y_INFORMATION,, a. .
Taspaver Name property Addeesy State Parcel Number Leeal Description:
Holly M Dunkel 652 E SR 56 26-02-58-015-002.301-018 PT MD 15 1 10 1.069 AC
HAZLETON IN 47640
complete and return to: IIIIVIIIIo!II111IC1MillEIICQ[IIIIIIIIil]D 1011101111[11011M
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
^4 a s .., .e. 4f7 -y+s r,1 .7 ± # n . ar + ,; y—srve =;`£ t . Q >tt
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OwnerI
Forst Middle Last
\\L\ McCG,C,t\� �UrN KC_(
Matting Address(number and street,city,state and ZIP rode) same as property address
Spouse First Middle Last
y-i MA.-k 6UnKe
Mailing Address(number and street,city,state and ZIP code)
Same as properly address
l)C3 6 S}2 S6 - Zle,\Un , \nJ Li-1U (-D
Social Semity Number(last 5 digits) Drivers License/State ID Number(last 5 digits) male Other(please specify in Part 4 belo.)
sc' uclt..! ?. Il°- '. . R 1;PAR .3:CE (FICA ION'
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 1 Signatrs• Date
( )
-V* 4! :2f,-7-:;141,:-'S' . PART 4 ADDITIONALINFORMATION -'_4 e �''° `
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10 17