Homestead_Pendleton� CLAIM FOR HOMESTEAD PROPERTY TAX ,;
' -CREDIT/STANDARD DEDUCTION � -
SLne Fwm 5473 (R6 / 4-03) � " '
' Prescribe0 by the Deparimeni of locafGovemment Finance �� -
INSTRUCTIONS: See reversc side tor Iiling instrt�clions. '
_, . v.�\ FORM
HC10
YEAR
�(1Ne1 ��.���i1G!/IA I/v +� �1l.E�l(.(_ �q th�(bn`(he �st d��i�arch, 20_
I(VJe) occupied as our principal place o( residence the following described real property for which a HomesteaB�Property Ta< Cred� is hereby d� ed:
❑ I(We) owned ❑ Are buying under contract ' �
�Have a benefidal interest fn the entity Uiat is liable (or the property laxes oo the property and that own5 ci�� �i5� �n�'i�i�`�er e co�traU.
If byvg on convact, Fee Simpla owner's name
RecoNefs oifice where contrad is remrded
- I 7o.vnship ' � . . . . ...I.7�ing tlistria (ciry,
Record num�er � Page
Parcel num r //� [��% L al descriplion %� Is the prope in queslion: �
olf/ � D/ Tv / ��� �� iV [��al DroPerty ❑ Mobile Homo (/.C. 61.1-7)
I( any portion of the residentlal sW cW re w Ne Wnd not exceeding one (i J aae tliat immeAiatety surrounds that s ciure is used b produce income, tlescri6a the use and portion
ot the properry uulaeA b produce incame.
Gibson County Auditor
101 N Main
PRINCETON IN 47670
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UPR 2 0 2010
u18SON,COU � N��ITOR
3426
;u, su�[a r�nv n-�a
IndrviduaL anJ marricJ coupin are limimd to orc homeaeaJ uandaN Jnlunioa As ihe rccrip� of ihis ANuninn hccwics
m�re beneficial, therc is morc incrntn< dun ner (or Aomrstead fraud Ilomo�eael fmuJ <auses highrr tac bflls fur all: therefar.
HEA 13di-?009 requ'ves uipayen ..�ho recci.r thc hwnesicaJ standard �kvluction m.cri( dut �6ry a`e eli�iWc m mcrne ihc
brnefil and �o pnn'idr aiNlitional iJenuirinc infomw�uon necrsary �o alluu� counn gurmmrni ro bener muniror humese:d
filim�. Tiis informa�im xill M Aryw confi�lrniial and can nnly h.: accr�snl br amhorirtd rnumy otlirials.'fhe Ikpannxnt nf
1_ocal Govamnem Fina�rce ��ill u.c this intortnatiun ro areatt 4vls thL �rill h:lp counn' offieial> dimfnak homestcaJ frauJ.
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T�spa��er Nrme Pro em• �
Pendleton, Robert A/Cheri D
IL E3ox 37% W /
Princetnn IN 17670
Robert A Pendleton —
34S180E
PRINCETON IN 47670-8961
�i�ii��in�i��n�ni���iii�i��i�i�in��nni��ii��n��i�i�i�i�
State Parcel Number
2612-09-302-001.457-027
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�ng Add�s (nwnber end strm. ciry. staee. and ZlP cade) ----- —
✓�`� 5; I POE �(L�,.ic�ic�n�� i.J %67U
Social
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C� eR�� I fl•
ilinc Addtc¢ (t�umber and sl:tt4 dq', slale, and "LII' cale)
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�ial
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Aliddle
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Leeal Description
006-01457-00 PT SW 9 2 10 .55 AC
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nsPropertvatlarccs—' — . � � _ __ ._
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:u propeny addrca� �
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undersienetl certifies, undzr penalty of perjuq�, that the above and foregoing infurtnxtiun is true and cortect and that he or she is elieiblz to
�e the homes�ead siandard deduction on this property. Each undersicned also understands that, by claiming additional homestead deductior
✓fully, he or sh y be liable for back ta�ces and substantial financial penalties. !
� i Sibme Vaic 7'cicphone ��
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