Homestead_Moore,\ ��`��""°< CLAIM FOR HOMESTEAD PROPERTY TAX
� � CREDIT/STANDARD DEDUCTION
� �� State Fortn 5473 (R2 / 5-92) .
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INSTRUCTIONS: See reverse side foi (ling instructions.
--� \ /1 CERTIFICATION
FORM
HC10
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YEAR
I(We) � V '� �� �� certi that on the 1 st day oi'FXarch, 79_
1�/Ve) occupied as our princi al lace of resi ence the following described real property for which a Homestea �roperty Tax C�redi �a'hereby claimed:
�1
❑I(We)owned b n undercon[ract L�"�'��—`vl� ,
Have a beneficial interest in the enN9 that is liable for the w e taues on the ro e and that owns the o� e� ��o� Ss'b Jn �untlera�con ct.
❑ �Y P P rtY P P rtY P P�Y �M 9 i.,,,, ;
If buying on conVact. Fee Simple
Recordefs office where conVact
If any portion o( th¢
the pmperty ulilized
name
TamShip
not
CONTRACT
PROPERTVC
�
acre that immea
PHOPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
number �Page
to produce incame, describe ihe use
�ereby certify the above statements are true, correct and complete. ?�
vl
ress umberands(reet,ciry,state,ZlPcode)
.� 3$ /9lo AH `{�i�.c�o-w- zN �F7G 7 0
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD
VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvements.
Otherland
Total land (line 7 plus line 2)
Dwelling
Residential improvements
Garage
Other improvements
Total improvements (line 4 through line 6)
Total value (line 3 plus line 7J
I hereby certify the above is true, correci, and
complete.
VeriMno actian - Sianature of Auditor
19_ Pay 19 _
Lesser of 1/2 Homestead
valu� or Sz,000
i�)
(2)
(3)
(4)
(5)
(6)
(�)
(8)
STANDARD DEDUCTION ALLOWANCE
S
NON-RESIDENTIAL
VAWE
signed
oace si� _�7 �\
� U �J
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Gibson Counfy Auditor
101 N Main
PRINCETON IN 47670
789
SIAiEl064 �JN� IR_! SW I
�� iRF.1SUREM1W0.4YlA
PI! �EPMMIYfUF l0.AL CFW2t Ma .i 14:A�'[E tt'�1.1-L'J.1
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InJiviJuaL. auJ nu:riN coupb arc Iimi�N to onc Iromc�raJ �tandarJ JNuninn. As ihe receipt oi thi� dedunion becomn
morc beneficfal, there is mwe incrntive than e�er (or homnteaJ fiaud. Ilomeuead i�auJ cau� hi�her �a� kfl6 (ur all: therefare.
HEA li+i-3M19 requim uipa�crs who receire ihe hanes�ead uandaN ANuction to .crilr tlu� �hey arc dieible io mecne �he
brnefii an1 ro pnr�ide addi�ional identifying intormaaon �rccr'vn� ro allw� county gv.rmment to bene' munitur hume7estl
filir�.�. This inlurmalion xill br Aryv cmllJeniial ami ren nnly Ft accnyed b�� autMmnl rnwly n�[i�l� The Ikpanmm� o(
Local Gwrmmem FinaM'e uill u.e �hfs infurmation eu areme nds �hm �rill heln eamn a�t�cvals eliminne homcsmad fraud.
Barry L Moore
2546 N Benchmark Dr
Princeton IN 47670-8522
�i�u��in����n�ni�����������������i����������i��i�����i��i�
T•rspacer Name
Moore, Barry L/Carolyn E
State Parcel Number
26-05-30-101-000.226-027
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Princewn IN'476J0
I
Lesal Descrio[ion
OOG00226-00 PT SE FR 30 1 10 .91 AC
I First Middle
��RR L-yN^� Nl DoRe
: Addrtv �numocr end imvt: ciry, sta�e. and ZIP <odc)— -' - — � - ' Sarc aspmpc: r ndd.:,s�
a��F-� N, /.�nChw�A2k17R.� �2iNeetaa�jTA1 �7�70
iccuriry Yumbn (last i diein) Driver's LicensdSUte ID Nmnbcr (last 5 digits) O�hcr (pleuc apeciCy in Pan 4 belaw�)
� .E�Qine
¢PO/un
lin� Address (Number and stm4 rii}', staie, u�nd ZIP cale)
d5Yla �% ��^%im��! ��`. Yr�nce�on�Z/i1 '/9G�0
al Saurity Numbtt (last 5 dieitsl DrivcYS Liccnsc/Statc ID N�unbcr (Iv[ 5 dic
�-
/�ao�e
ai pmpem addres,
4
mdersitmed certifies, under penalry of perjury, that the abo�•e and furegoing information is We and correc[ and that he or stie is eligible to
e the homestead standard deduction on this property. Each undersigned al;o underslands thaL by claimine additional homestead deductions
fully, he or she may be liable for back taees and substantial financial penalties. I
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