Homestead_Dike (3) STATE FORM!!!MIr:HMI TREASURER TOMM TS-IA
.APPROVED BY STATE BOARD OFMxxL\MS.YrM PREYRIBED BY TNT UFPARTS4YTO fLOCAL GOVERYMEA'T FINANCE M4-I.1-11'4 I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples ate limbed 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 1347-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to teethe the
benefit and to provide additional identifying infomummn necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only be accessed by authorized county officials.'The Ikpanment of
Local Government Finance will use this information to create Lids that will help counts'officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Dike, Paul A/Nancy C
407 N West
Fort Branch IN 47648
6746
Paul A Dike
407 N West St State Parcel Number Leal Description
FORT BRANCH IN 47648-1043
II III I II I 'III I I II II I III I 26-18-13-401-000,335-026 011-00336-00 PT W SE 13-3-11 .266 AC
•
to nt r ntn a nu ruenn t ur nr t n
-- — --
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
Sole
Spo First Middle �\ f62 Last
larai C. /II AI TpA
Mailing Address(N bcr and street.city,state,and ZIP code) [ tame as property address
Li 07 N • 1 r+ &anc� / rinl" �G7 � B
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
� t CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� Slate Fwm 5473 (RB / 403)
PresrriEed by lhe Departmenl of Local Govemment Finance
INSTRUCTIONS: See reverse side lor liling inslnufions.
FORM
HC10
: '9
YEAR
� M'e) �' ceNry th C Cnpthe� 1 s� �XQ�arcn, zo
I(We).oaupied as our principal place of residence the 'ng described real property for vfiich a Homestead Prope�ty T�c G�e �� eby daimed:
Il� I(VJe) owned ❑ Are buying under contract /�/ (/.J�J /�
� Have a benefidal interest in fhe en6ty that is liabie for the property laxes on the property and �hal owns it' ,e property�a�is_ buying under a co iVaU.
If buying on conirad, Fee Simple ownefs name
Remrders ofica where conVad is recorded
County
Parcel number
7wvnsniP
Eescrip4on
J 1 1_�!� J.J:I�GZJ 1' W.
H any po onN o/ the resitlenllal sWqure w �he land not
oF the aooertY WlizeO tn produce inmma.
Is
one (1) aae IOat imme0iatety wrtoui
Record number � Page
tawn.
L Real property ❑ Mo�ile Homo (I.C. 61.1-7) .
that sWCture is used tn produce income, describe the use and portlon
. , �F'"t�.�'�Pe,.i��-��.TFan"��'3s:�(i, ^`�� � _ '":ro��i,�h.�s�vu's",�.F'�2��� '. ' �'
._:. ". - ;-,.{�s„��s,. tiq.w e _„ � .-.,STANDAR�'OEDUCTION'ALCOWANCE w� ' �.• r- .,�� �. ,�. � - �-_-ce
� 2w,z Pay 20 � .
Lesser of 1l2 Homestead S
VauaLOn or 535.000
Sgnatureoflwditw � Datesigned