Homestead_DealCLAIM FOR HOMESTEAD PROPERTYTAX
CREDIT/STANDARD DEDUCTION
Stete Fortn 5173 (R614-03)
Preac�iOeC by tlie D�a�tr�roM d Lural Caovxnment finaxe
INSTRUC710NS: See rewrw aida b�ifp inebuctionc
FORM �� YEAR
I(VJe) /A/��� `� � �/___.� �(� �iF � certify lhat on'thZj�Y�st dayyof�Hlarth, 20
I(We) occupied as our principal place of residence the following described real property for which a Homestead Property Tac Credit is hereby daimed:
�(We) owned ❑ Are buying under contract GIBSON COUNTY AUDITOR
' Have a benefidal interest in the entiry Nat is liable far the properry taxes on the property and that owns the property or is buying under a wnVaU.
I( buying on coniraq, Fee Simple owners name
Counry
Parcel
N any poAion of
ot ihe Drov�Y �
conVaa is recorded
�`�i��''!s��.:'��`�3�°a��_,`�.�.''s4°' ��,. i�l
� � Tawnship
L al description
�
lentlal sW cWre n Me land not exceed' one (1 �
Record number � Page
ihe P�� N queslion:
� �eal property ❑ MoCtle Homo (I.C. 6f.7-7)
wrrountls that sWCture is usetl m produce income, tlesaibe the use and portbn
� - ����"����'��"�`� �� � '� ��TR TA�X r��-�`% �ASSESSED VALUE `��`�HOAAESTEAD�� ; NON�`-,RESIDENTIAL {
�-.�.�; �550§�.�ONLY,,,. .:°. � 3.��VALUE��t � .3/1T�100°h'OFT�JV� �`��VALJIE��`.''�-� ��`�; VALUE���
Land not exceeding 1(one) acre immediatey �� � �'�s`"�',L����•�i,°.:�°r�'�'�*���
surrounding residentlal improvements. ��� � ��z. � �.,`.�:��: {;
��_-; . - � . ..
Other land �z� �?�j,��,��
'�t'--
Tdal land (line 1 plus line 2) �3�
--�`- E -�r �
Dwelling (4) � ��� �� � � ��
�Residential fmprovemants w MnuaOy ����'w�.�%.a��s..� '�*�
Assas�d MoE6e / ManufaWUed Home Garage (5) � Y� � . `" �d�1' `
; � � ��?
Other improvemenis (6) r�""'''� �'� s
l �r� :��e�_ �.
Rlal improvemenfs (line 4 through line 6) �7�
Tdal value (line 3 pl's line n (g)
I hereby certi(y ihe above is We, corred, and Signanre otnssessor Date signed
complele.
Verifyi�q7 action - SignaNre of Auditor Date signed
���a-. ���'"ati���?s�i'?3�r�y,��'�;`STANDARU:DE�UCTION'AL'COYIIANCE?i'�,X��-,''''�`�<.��"'�-s-"�-,"�`_,:ti��,f�'�'.'.^'�,`�..�--�
20_Pay20_
�esser of t/2 Homestead g
vauanon a f35.000
Signature of AudHw ' Date signed
surcroam
iPFA54RERf00.y:11.�
_ .. . . ... ._...�...,. _.,_� ...............Tfp:A\CEICbI.I-�A.1
Gibson County Auditor
101NMain '�' � � � . 1 '•1' • � •
PRINCET�N IN 4767� hidividuals aud nu;riN couple� are IuniiN m onc hnme�caJ �andaN cicJuaion. As �hx rcccipt of �his dMunion bcconMs
murt benencial, ther< is more incencn'e than ncr for homestead fraud. Ilormrcyl frdud causes higher Iax 6ills tor all: thertfa<.
� HEA I3�t1-3009 requim tax{u.ers who receire thc hanestrad suMard JNuction �o veriiy that they are eliciMe to recene the
��a �� brnefii aM to pra'idr aJditiorul idrntifi'in� information nec�-vrr b aliw' oounn� ern'emmm� ro b:imr monrtor Mmrncmi
� filirp?. This infarmaiion w�ill be Aep confidwial anA nn only F.: arcec¢d b� autMr'vN munp� oft'mi�als. The Ikryunnxnt nf
$- J Local Gmertmem Fim�rce will u�e this iniormation W crw:c twls tha� will h:lp camn' of�icial. <liminai< Irom<ACad FrauJ.
� � � � . � "
— APR 7 Z��O TasparerNnme
_ Deal, Dean M/Lynda J
sa$��go� � �� ITOR � . � � .
1/"
Prnpertc Address
3?03 JULIE DR
PRI\C6f0� IN i7670
Dean M Deal �/' a_ t� a�
3203 JU—_ LIE D�f —�� State Parcel NumAer Lesal Description
PRINCETON IN 47670-8120
I I'I I II � II I I I II I III I I II I�I 2Fr11-15-101-003.949-027 006-03949-00 SANDY RIDGE EST C 43
� u u� � u u� n� n uu u i ni n ni n n ' D-17
_. _.. ._ . — . .—_ '.'__. __..___ . . __ . Y - _ ._
This form MUST be retumed to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
�� �
Owmer 1 /^/ First Middle /^�/ Lut
'V� � "V
�e Addmss (nem6er and sam. ciry, itate, and ZI P code) � Same ns pmperty addles.
a s s 3 r,r/. du-�e°�� �°�� ,,�• 5� 7� �O
$ocial
Middlc Last
y«��- �w� � ��c�
Mailine Address (NUmber and slree4 ��y, siate, and'LIP coJe) �amc as pmpeny adJres;
�.s � � � . �. � P��-� �.�.. � �� 7D
.
Sxial
�
,. . �
Each undersiened certifies, under penalty of perjury, [hat the abo��e and foregoing infortnation is true and correct and that he or she is elieible to
receive the homestead standard deduction on this property. Hach undersiened also understands that, by claimin¢ addi�ional homestead deductions
unlawfvlly, he or shz may be liable for back taxes and substanrial financial penalties.
�M� � 5,��� n�� �,� ,�,�%�
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