Homestead_Lucas�; CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
/ Sute Fortn 5473 (R6 /1-03)
Prescribed �y the Department ol Local Govemmem Financ_
INSTRUCTIONS: See ievcrsc side !or (ilinq ins6uclfons.
FORM
HC10
YEAR
��e� � \ 6'�VK'��V �'�^" --+� `• � fy t�hat on the 7st day ot March. 20_
cerli
I(We) occupied as our principal place o( residence the foliowing cribed real property for which a Homestead �rp`�p�tty�Ta� C�{� hereby daimed:
❑ I(VJe) owned ❑ Are buying under wntract /�
� Have a beneficial interesl in ihe enfity that is Iiabie for the property taxes on the property and that own�s the property,or is buying under a contraU.
If buying on conVad, Fee Simple owners name
Rerorders ofice where mnuaq is recorded
CounTy
If any portim c
ol the proPerty
County
Record number � Page
Tamship T�ting dislric� (dry, (own, townshiP)
g I e "pti � j Is the pmperty in question:
W �' � I ❑ Rea� GropeM ❑ Mobila Homo Q.C. 61.1-�
sWCNre or the land na axceedinp rna (1) aag�R�('.un �tery wrrounds that swcwre is usetl to protluce income, descnbe the use and portbn
ice i�ome.
s<i `��
Tavnship
I hereby cerlify the above statements are W e, correcl and complele.
Addreu (num6er aM sfreet, city, state, ZlPCOde)
Land not exceeding 1(one) aae immediatey
surrounding residentlal improvements.
Other land .
Tdal land (line 1 plus line 2)
Dwelling
Residential improvements or Mnuatly
0.ssessed Mobtle / Manufactured Homa Garege
Other improvements
Tcial improvements (line 4 through line 6)
Total vatue (line 3 plus line �
I he�eby certify fhe above is W e, corred, and
complete.
Verifying ad"pn - Sigrature ollwdimr
Signature ol AudRw
20 _ Pay 20 _
Lesserof 1/2 Homestead .
vauanon a 535.000
W
I�1
i2)
(3)
(4)
(5)
(6)
(�)
(B)
of Asseswr
County
�
al
Y% • a�..ti.,,�.
Data signetl
Date signed
�
6
Gibson County Auditor
101 N Main
PRINCETON IN 47670
aUiE f[�1n1.�Vw Ill'I w'1
InJiriJuaL. anJ mi:rieJ coupia arc IimiiM io nre hnmeueaJ �amfaN JNunion. as ihe receip� of iNs �dcdunbn hroma
merc beneficial, tlarc is morc incenme th�n e�er for homnrc;kl frauJ. Ilomd�eazl frmul caass higher lac bi`Is ibr all; �he¢fae.
HEA IS3;-'_INW reqvim uspaprn x�ho receirc Ihe hanesecaJ S�anda�d dcylUCtlup b vC111V �I01 lhf� � CII4IMC 10 M1YfnC IhC
benefit aM tu pmvidc adAitimul iJentiiyinc infwmation necrssarr to allow' county ewrmmenl ro bener�muniror Iwmesm:d
filin�,�.'ITis inlamution will br Aryx crnlidrn�ial and ran nnly he aace+.ev1 hp amlwmnl couny� officinls.�T3r Ik�.inmrn� of
I.ucal Guvcmmcm Pimncc �vfll ux �hfs infonnation w u<atc [wLa �ha� will hcln camn' ufficial.r elinvnafe huma�cad (nuJ.
1629
Robert N Lucas Jr
602 S Old St Rd 65
PrincetonlN 47670-8591
I�I��II���I�II��I���III���I��I��I�I�I�I�����IIII�����I�I���III
na 1 Ffrst
�i ober � N�ble
�c Address (nembcr mid stcect, city, smte, nntl GIN code) — �—
(p�� �. �Gi ST�#e �fGaU .7
:ial $murit}' Number (Wst 5 digiLS) Driver's Li<rnse/Stat< ID Nmnber Qasl
�-
Address (I:umber and s�m4 ciiy, sWie. und "LIP code)
Stturin� Numbcr (lact 5 di¢iu) � Drivcrs LiccnsUSUtc ID
5
Tnina��er Name
Lucas, Robert N Jr
R'cll rt 06-OS?
/%�� Pnnccton I�
State Parcel Number Leeal Descrip
26-11-16-100-001.215-027 006-o121soo PT E N
/ D-17
✓
n
U�as, ��•
�: Ili �lN'(rirt}' Gu'�i1Lw+— _—
, .Lr� `f ! � �i
� Sune u pmpeny :ddresi
bclow)
V 16 2 11 34 AC
mdersibmed certifies, under penalry of pepup�, that the above and foregoing information is we and wlrect and that he or slie is eligible to
e the homestead standard deduction on ihis propeny. Each undersigned al>o unders�ands that, by claiming additional home;tead deductions
fully, he or she may be liable for back taxes and substantial financial penalties. I
I Sicnaaae _ . �J Us�e� 7'cicphonc
-�
( )