Homestead_Dunn (11)Gibson County Auditor
101 N Main
PRINCETON IN 47670
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undersigned certifies, under penalry of perjury�, that the abo��e and (oregoina information is we and correct and that he or s6e is eGeible w
:e the homeslead standard deduciion on this property. Each undersiened also understands lha� by claiming additional homestead deduciions
��fully, he or she may be liable (or bac:t taxes and substantial financial penalties. �
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FORM HC 10 7979
HexribeE By State Boartl al Tm Cammissioners
Ta Be FileE in DuD���ate
CLAIM FOA HOMESTEAD PROPERTY TAX CHEDIT FOR YEAR 19 �s
SEE BACK FOR FILING INSTRUCTIONS
�(We)
as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) C-� owned OO/ � oOS� �
❑ are buying under contract �O
❑ have a beneficial interest in the taxpayer �n
Property Description in � County `�'�� Township
Taxing District (City, Town, Township): `�'Q�-a-� ��
Parcel Number or legal description shown on tax statement: .
PE sF�ks aq-�-.o �. �s�.
If buying on contract: Owners name ��� simo�e o.�e.�
Contract recorded in Recorders Office - Record No. Page
If any portion of the residential structure or the land, not exceeding one (1) acre that immediately surrounds that
structure is used to produce income, describe the use and portion of the property utilized to produce income
Any other counties in which individual owns or is buying real property:
�hereby certify the above statement is true, correct and complete.
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Sveet
County Township
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ciry. 5tare and Zio �e
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
� � � ^ �.
Land not exceeding 1(on�acre immediately
surrounding residential improveme s1 �g�g.
Other Land JU� - �
Total Land
Residential Improvements�, �
A/��9
Garage
Total
Other improvements
T�Improvements - Line (6) plus (7) equals (8)
I i���aby certify the above is true. correct. and complete.
AssessOr
>
True Cash
Value
(1) 50 �
(2) Po
(3� a��c
(4) /�f3oo
(5) / Y <5—a
(6) / 6 I � o
(7) SP U
(8) /�73 0
- ACTION BY AUDITOR -
»
Assessed Homestead
Valuation Valuation
0
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