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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 5473 (R2 / S92)
INSTRUCTIONS: See reverse side /or liling instructions.
FORM
HC10
YEAR
CERTIFICATION STATEMENT _,,;
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I(We) �v ' t �e ch, 79_
I(We) occupied as our rincipal place of residence t following described real property for which a Homeste�ro , .� x Credit is hereby claimed:
❑ I(We) owned ❑ Are buying under contract �1(�V j u 1999
❑ Have a beneficial interest in the entiry that is liable for the property taxes on the property and that owns the pf�perty dF is buy g under a tract.
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CONTRACT RECORDED `"-"rj.J 'j0R �
Ii buying on convact, Fee Simple owners name a�8$ON �'�' �
Recortler s oHice where contract is recorded � Recortl number Page
PROPERTY DESCRIPTIO �
Counry Towrss Tacing Oistric fown, ( wnship)
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Parcel number Legal description
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11 any ponion ot the resitlential structure or the land not exceetling one (1) acre thai immedia[ety wnounds that s'uucture is usetl ro protluce income, describe che use and portion ot
Ihe property utiizetl to produce income.
PROPERTY OWNED BV CLAIMANT IN OTHER COUNTRIE
Counry Township . Counry / TownsNp
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Signat� nt � r�
�ereby certify the above statements are true, correct and complete. � �
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Address (num andstreel, city, srate. ZIP code) �
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ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately (»
surrounding residential improvements.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwellin9 (<)
Residential improvements
Garage (5)
Other improvements (6)
Total improvements (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true, conect, and Signamre of Assesor Dace signetl
complete.
Veritying action - Signature of Auditor Date signed
� � STANDARD DEDUCTION ALLOWANCE
. . 19_ Pay 19 _ -
sser f 1/2 Homestead �
alu ion or $2,000
Signature ol Autlitw � Oat gned
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
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Indiciduals anJ ma:�iN coupks are IimimJ to one homeucaJ uandarJ dcvlunion. As �he rereipi oi �hi��Jeduai�n becomes
merc beneficial. �herc is morr incrn:nx than n<r (er homesrcad fraud. Hortb'tead freud causes hi�her taa bills tor nll: therefore.
HEA 13ii-?IXW requim Incpayen xlro rccci��c Ihe hancstcaJ <undard JrJuction m verify �hat tM1ey are e�iGihlc lo recene tlrt
Mnefi� anJ to p�a'ide aJUiiio�ul ideneii)'in_ intwmation Mces'vn� ro allou' cwnp� ernemmrni to N;r.�� monitw IwmesreaJ
tiling+.'lliis in(omu�ion x�ill be Ae7w mnlidrniinl and nn nnl�� Fie acce. xd M1. amlarimJ cnunry� oRcivl�i Th< IXpanmeni nf
Lacal Gorcmmcm Financ< will n.c this in(ormazion W�reate rools �Mt will he:n cvunn� offcial. dim�wlte Ixemcnead fiaud.
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Danriy L/ Judith K Oglesby
Pa Box 1299
Princeton IN 47670.0999
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Taanarer Name
Oglesby, Danny L/ Judith K
State Parcel Number
26-12-06-201-001.734-027
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d$ccurit}' Number (last 5 Jiei�s) IMvers Littnx/S�atc ID Number (lazt 5 dieils)
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Each undersiened certifies, under penalry of perjuq�, that the abovz and foregoing infortnation is we and coirect and that he or she is elieible to
receive the homestead s dard deduction on this property. Fach undersigned al>o understands Ihat, by claiming additional homestead deductions
unlau-fully, he or ma lia le for b ck taxes and substantial financial penal�ies. I
Owner 1 $ibms [htc Tclephonc
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