Homestead_Fullhart„..,.,,
,���� CLAIM FOR HOMESTEAD PROPERTY TAX
i� CREDIT/STANDARD DEDUCTION
�, • Sute form Sa73 (R2 / 5-92)
u,•
INSTRUCTIONS: See reverse side for liling instruaions.
FORM
HC10
YEAR
. . . : .,- . .” -.� -... �CERTIFICATloN sin7ee�7Enr - . ��"�- .- - � . .
, . .� . �.�.--'-
, �- - . � . - . ..�. ., —< :- . ; . . . .
�ie� �_ �GG � certity that on the i st day of Mamh, 19_
I(We) occupied as our principal place of residence the tollowing described real property for which a Homestead Property Tax Credit is.hereby Gaimed:
❑ I(We) owned ❑ Are buying under contract � A ��
i�1 �� `� . ��.1/� �, ,
❑ Have a beneficia� interest in the entiry that is liable for the property taxes on the property and that owns the•property o�is�b ying under a contract.
If buyirg om m�iracl, Fee Simple owner's name
Recordefs oHice where contract is remrded
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�Fiecoid numt
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�.-�{nyy.. //�t-.=,�:.
.�t�
Page
Counry TownsNp Ta<irg dis[rid , town. fownshrp)
l�S'v fl'7?)/� � fl- � �s,��
Pa cel nu ber legal descnption
D �- c��// -o c�
If any portion of Ihe residential structure or the lantl not exceeding one (1) aae that immediatey sunountls Mat structure is used to produce income, descnbe Ne use and portion
ol the properry utilized to produce income.
- .� -ASSESSOR USE ONLY
Land nm exceeding 7(one) acre immediately
surrounding residential improvements.
Oiherland
Total land (line 7 plus line 2�
Owelling
Residential improvements
Garage
Oiher improvements
Total improvements (line 4 Ihrough line �
Total value (line 3 pUs line �
"+ereby certity the above is true, correct, and
�iplete.
VenM1vio aaion - Sianature of Auditor
19_Pay19_
>ser of t/2 Homesiead
Valuation or $2,000
TRUE TAJ( I ASSESSED
VALUE VALUE
(ll
(2)
(3)
I4)
(5)
(6)
(�I
(8)
Signature of Assessor
5TANDARD DEDlJCT10N
5
HOMESTEAD
VALUE .
a "' • .
a °`
NON-RESIDENTIAL.
VALUE � •
Date signetl
Date signed
DaCgt sign`ed'
_ - ° — /
•
Gibson County Auditor
101 N Main
PRINCETON IN 47670
4008
Patricia A Fullhart .
R1 Box 281 A
PrincetonlN 47670-9270
1PfA5114[R f00.V Zln
l�w Ptf_V(AIPFDBYi�Il�L�MiMYflLLI�'ALf i�VM(TTiPP�\f[I�'��+�>`��
InJiriJuaL+ md martinl mupks are limncd to one home�teaJ �andaN d Vunion. As �he rereipt ol' Ihis dcducticrn beconre:
mort beneficial, thtte is morc i�en[nx than rcer (ar homcsteaJ fquA. Ilortrtm»exl frnud canses hi�htt ta��6ills fur ull: ihertfore.
HEA 1313-2IXl9 rcquvea taxpa�ers who reccire Ihe hanrs�raJ sundard drlunion in .erilv tMi ihc} a(c <lieide io rccci.c the
brnefit an1 tu ��;ar aNlitiunal iJrntif}'im_• iniurmation Mcr<vey ro allw' couniy gmrmrtkm lu benrr munitor humrsttaA
filin�„�.'Ihi� in(mmation will M Ae�M confiJenlial anA can nnly M acectteJ hr autMrimd rnunh' n(ficial�.'I'he Ikpanmenl nf
Lucal Gurcmmrn� Fimncc will u.c this fntormation ro arca[c twls �hat o'ill h:Ip cqmry' ufficials diminnm homamad fiauJ.
.�� �. �
T•rxpacer Name Prnnern� Addresx
Fuilhart, Patricia A �I
� ki i3�t zxi n
Princctnn IN -07670
. .� .
State Parcel Irumber Leeal Descnnlion
I�I��II���I�II��I���III���I�I����I�II���III���I���I��I�II�I��I 2s-12-18-404-0o2.11s-027 oos-o211s-ooPTSE 18210 tAC
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I
Address (numbcr and itrcM, city, smtc, and ZIP codc)
3 %�o �. /50
Number (last i dicits) � Driders Licenx/Siaie
��
m�aai<
�_
anbct (la;t 5 digits) Ochcr (plcaci
� Same u pmpeny adJres
in Part 4 bclow)
undersiened cerrifies, under penalty of pepury, that the abo��e and foregoing infortnation is we and correct and that he or sFie is eligible to
:e the homestead standard deduc�ion on this property. Each undersi¢ned also understands that, by claiming additional homes�ead deductions
,�fully, he o; she may be liable for back taxes and subsiantial financial penalties. �
Sicnanue
Si�a[u;e
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