Homestead_Hardiman (14), t;, CLAIM FOR HOMESTEAD PROPERTY;TAX
CREDITISTANDARD DEDUCTION
;♦ i: s�:�mF.,,ms.:�alksi4-o3; . ,
Presaibe� by the Departmen� of Local Govemm=nl Fiiiancc •
fNSTRUCTIONS: See revcrsc side lo� liliny'ir,.lrutfi��ns
FORM YEAR
' HC10
��, J
� ..;y:• � :. ,e_ � _ � - I AiION STPlTEMENT.. s :: �- - . _ - .
I(We) _ ' certify that on the 1st day o( March, 20_
I(We) occupied as o r principal place o( residence th owing described real property for which a Homestead Property T�c Credit is hereby daimed:
❑ I(We) owned ❑ Are buying under wniract � -
' Have a benefidal interest in the entity that is liable for the property taxes on Ihe property and ihat owns Ihe property or is buying under a contract.
�=�`�".'r.xSc�Y'.nF t-F. _ i�'� ��.. ..;._e: -r ,_,. ��.. .s -•-CONTRACT.'RECORDED'?;; : . . . .. . :.. ... . . �
If huying on contract Fee Simdo owners name
Recordefs of�ce where conGacl is recordeE
Counry
Tamship
-FJ-`1 �'/� ��°�-� I_I�- L `/_
n o: ihe residential strutlure w the Wnd not exceeding me (1J acre t�al
rty u:ilcetl ;n protluce inwr.ie.
Coun(y I Twvnship
I hereby certify the above sWtemenls are lrue, correct and complete.
IRewrd number Page
ESCRIP.TIONi•`Z...':s?'T.`'{"•�� :" �'�a. � - � -
Tacing di5�rict (ciry, fown, lownship)
Coun�y
IJ
�
Real propeM ❑ �bile Homo (/.C. 67.7-7)
ve is used lo protluca income, tlescri6e Ihe use and portion
`ar � � r �"� s �' � *` } '' i y �h�f � � TRUEcTAX � ASSESSED VALUE "sHOMESTEAD � �X�' �T' NON-RESIDENTIAL --
4.,i�t.F Lr ASSESSO �USE ONLY �.�� � �?}_ �# VALUE AT 100°h OF�TTV� ,Fg;.�;VALUE� F-�� �."� �a �]�, � VALUE`
lanA nol exceeding 7 (one) acre immediatety : h"`g $�- '" � •''a'� ` ;� j �'_; ,
surroundingresitlenfialimprovementa (�) �'�;��'o•,,e����::._�t: �.�':�
Ofherland (p� ``x�.,�� ..�,[� `+'
-.f`• - -�',•��„�..si
:>^Li . -
Tdal land (line 1 plus line 2) (3)
-` �3�a�' t '...��� i '.
Dwellin9 (4) ' `�r�'�-r�c�a?.,-'�� �-b
Residentiel improvements orMnually ..
Assessed Mobila / ManufxNred Hane Garage (5) �"�-' �'� ��'"y� f�"� �.,'s.. �?.
�.,...v:a.. _ ��. �dr.:..
Otherimprovemenls (6) "r'}��-„�z -�,
- " '.S%. cli::.:,..:..
Tdal improvements (line 4 through line 6) (7�
T�al value (line 3 phs line n (8)
I hereby certify ihe above is We, conect, and signamre othssessor oate sgnea
complete.
Veritying action - SigrmWre of Putlitar Date sgned
20 _ Pay 20
' Lesser of t/2 Nomes;ead
vawauon or 535.000
SgnaWw of lwdila
5
�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
226
I
iTAiE fORY �! W IL /!'+'1 '�NASUtfA fO0.V 7-IA
OY it�C OflA0.T1EY� (rt IA:LL
IndiriJuaL. and mvriN <oupla art IimitN m onc hmmc.tcad �tandaN A,�lu.�ion. As the recript o1 this dedunion becomes
more beneficfal, thrrc is more incentne chan rc<r (or homesteazl frauJ. 17omesttad frsud causcs hi�her ta� hilts ior all: therefae.
HEA G+3-?OW requ'un u�pa�en who receire �he hanes�caJ standa�d JNuction �n veril'y ihat �hey me eli�iMe m receice ihc
benefii ani ro p`w�iJe ai4litional iden;iiyirc_� infwm�tion necr.�arv ro allo¢� counh� ememmem ro bener mmi�or IwmesreaJ
filin��. This inlormaiim will be {.ep cm�fi�enlial and qn nnly Ft aett�snl by authorvtvl aounry� o�Tftials.'fhe Ik�wrmrem of
Iw�cal Gm�rmnem Pinance aill u.c �his iniormmion [o crcate erols thai a911 h:lp cwnry ufficials elimina�< homorcaA fiaud.
� � � � , � -
Taxnaver Name Prnperh� Address �
Hardiman, Ray A/Shelty R �
� R3 � W�
i
PrincetonlN;7670 �
Ray A Hardiman � �
R3 Box 163 C
PRINCETON IN 47670-8504
I�I,�II���I�II��I���III���I„I��I�I�II����I��I�I�I��I�I�I�I��I
State Parcel Number
2s-ossai oaooa. i �s-o2�
-- — �
J
Leeal Descriotion
006-04175-00 PT N W 32 1 10 3.999 AC
This form MUST be returned to County Auditor's office. �
Please do NOT send this form back with your tax payment to the county tr��asurer.
�`�/ I
(number mid imxt, city, smte, and ZIP <ode)
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�S
$auriry Numbe� (last i diG�s) Dri��ds Licevse/Sta1e ID Nmnber
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x��� � First ^��
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K
me Address (Number and stree4 ciiy, state, and "LIP code)
0��55 �! SjX�/� ��J �� ��-,,
� Saurirv Number (� 5 di¢irs) Dri�ds Liccosr/Succ ID Number Ilai� 5 dicicsl
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Snmc as praperN eddxcss �,
--.��% y%l� %C� '
fy in Part 4 bclow) '
/ J'fi�Ji��9.�/'
�Samc as prapeny addres;
>,,,� �,� S'7� 7��
Each undersiened certifies, under penalty o! perjury•, that the abo��e and foregoing infom�ation is we and colrect and that he or she is elieible to
receive the homes�ead standard deduction on this propeny. Each undersigned al;o understands that, by claimine additional homestcad deductions
unlawfully, he or she may be liable for back taxes and substantial financial penalties. �
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/1 ,U�C�ri�
reL- �eiepnme