Homestead_DaumN* . CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
'y � State Form 5473 (R4 / &00)
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INSTRUCTIONS: See revarse side (or filing insWCtions.
FORM N YEAR
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I(We) d/� ""'��' I certify that on the 1st day af March, 20_
I(We) xwpied as our prindp I place of residence the following descnbed real property for whirh a Homestead Property Tac Credit is hereby dauned:
� I(We) owned ❑ Are buying under contrad
�iave 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 contrad.
II Wyug on conVact Fee Simple ownets nartre
Recorders ofice where contract is recorded . I Record number I Page
�d�� :cy�.s�--��, �' - :•„,�,-:�,�PROPERTj.'Y�ESCRIPiTION��'-s�-`�' �a,�„�7�''�'.'�:rvis� 's �._'a�t,,"�:�
Coun , f� I Toxnship Tacing tlislrict (.� o rp) "�'� - '
y. .,.. < < /Gd
Pa I number Legal desaiption
i06 �' ��i 7 �i — O �r �
If arry portion of the residenlial s Wctu2 or Ne lantl fat exceeding one (7) afie Ihat immediatety surtounds Nat structure is used to p�oduce mRie, desrli6c -the ��5 pwtion
of Ne property u6Lzed �o produce income. - � �i � �� �� . .
� . oEC � �� 2�01
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I hereby certify the above slatements are We, corred and complete.
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r30 _ Pay 20 _
Lesser o,t �12 Homestead
Valyeuoryor 86,000
Sgnature of Auditw
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-Y%—o /
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Gibson County Auditor
101 N. Main StreeY
Pnnceton,iN 47670
STATE IORN S1569 ry.l /&I�
lRFA31.'NF.ufO0.MlS1/.
� Individuals and married muples are limited to one homestead standard deduction. As the receipt of this deduction hemmes
o more brneficial, there is morc incentivc 1Iw� cvcr (or Iwmatcad Gsud Homatead (aud wuses hi�er uz bills (ar all;�thcrefore,
HEA 13M-?009 �equ�s uxpa�ers wtro cecei�s t6c homcstcad sraadazd deducrion ro�srify ctut chey art eligible to reccne the
benefil and lo prm�de additional idrnofiing in(ormaiion nectswry to allow cwmry ga�emmenl to bentt moni[or homestcad
filings.'Ifiis infortnacian will bc kcpt wnGdcniial and can onW bc acccssed by authorized counry officials. Thc Dcparvnrnt of
Taxpaver Name
Daum,Trevi
Location Address
7670 Dunlap DR
PRINCETON IN 47670
152
Trevis J Daum IIII�I�III��II III I��III�II I��IIII�II�II��II�II�IIII�I�I�III�III I��II�IIQI�I� II II
1670 Dunlap Dr
PRINCETON IN 4767a8630
III'�'���'��'I��I���I'�II'�II""I���I'I'lll���l'I�����I�"�I'��� State Parcel Number � Leaal Description
26-OS-28-300-003.749-027 / PT SE SW 281 10 2.00 AC C-1
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APR 19 2011
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This fq����,,'� ��rned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
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Address(n^wnbcrand
I� io
ciry, statc, and ZIP
az property addmss
O[ha (please specify in Part 4 below)
Address (\umber and strat ciry, stau, and ZIF code)—. --_- _ _- _ _ ' -_ ' ' '_ __ __ � Same as pmperty'address — .— _... _
ecuriry N�ber (la5t 5 diRits) Drivcr's Licensc/5tate m Number (last 5 digits) Od�a (pleau specify in Part 4 below)
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undersigned certifies, under penalry of perjury, iha[ the above and foregoing infortnation is We and correct and ihat he or she is eligible to
+e the homestead standard deducnon on this property. Each undersigned also understands that, by claiming addirional�homestead deductions
�fully, he or she may be liable for back taxes and substantial financial penalties.
1 Sigianm
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