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Homestead_Sinkhornf;� CLAIM FOR HOMESTEAD PROPERTY TAX i� '� CREDIT/STANDARD DEDUCTION � State Fortn Sd73 (R2 / 592) •� w• INSTRUCTIONS: See reverse side lor filing instructions. FORM HC10 YEAR � ,�. �r.- N . .. .., _. .: _:.. ... .; . _ , ,-., - .. , . . . --r= _ CATION STATEMEHT." �'- -.`, - . _ , . ' _ . , ... , . .. .. .�y � .,- I(We) — - - ce a• n e tst��','{i o'f-March. 19_ 'e) occupied as our principal ptace of resi ence ihe tollowing described real property tor which a Homest�o�yrt c�r��it� hepietiy'daimed: I�I (We) owned ❑ Are buying under coniract �,,�,�p�(� �1 '000 ❑ Have a beneficial inierest in the entity ihat is Iiabie for the properry taxes on the property and that owns ihe ppper[�nris �yN� under a contract. Ii buying on contract, Fee Simple owner's name Recortlefs oHice where contrect is recorded PROPERTY County TownShip P be' QQJn(��% /\T Legaltlescription v7 I �� tl any portion of the residential struaure or the WM no� ezceeding one (1) acre that of the properry utilized to produce income. PROPEHTY OWNED BY cenify the above statements are irue, correct and complete. numbe� and sneq� dry. state, ZlP code) n ' � � )RDED�� _ � '" � Y� v'�---`� - a,:,: � .r � � _ .r:.yBl7na` GIBS � �,:,�.,<.: Record num6er Page il ON ' - �-_. - �<_- . . dis " ry. roxt`. wnship) wrrounds ihat swaure is used to produce income, tlescribe the use and ponion COUN7IES ASSESSOR USE ONLY � THUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL , VALUE VALUE VALUE . VALUE •. Land not exceeding 7(one) acre immediately ,� �` � surroundingresidentialimprovements. (�) �� � �� � Otherland (p) � .. _- , Total land (line 1 plus line Z� (3) Dwelling (4) � � . ` . Residential impmvements � � � _ Garage (g) �� Other improvemenis (6) � Total improvements (line 4 (hrough line � (7) 7otal value (line 3 p�s line � (g) I hereby Certify ihe above is IrUe. correct, and Signamre of Assessor Date signed complete. "=ntyirg action - Sgnature ol Auditor Dare syned �- STANDARD DEDl1CT10N ALLOWANCE'" � � -s:. � 19_Pay19_ Lesser of tl2 Homestead Valuation or 52,000 � Sgnature ol Auditor Da;e signed ( ' !~\ � .R�iEf110.M�!K10./��MI � IAFA$UAE0.PoR4YIA ���M1!*'EI1BT�I�Tf.IXMPUOi.i([�tnitY�+ p[fAllllBmBYTIfOE�ARMf.YfIFUAALCMeR.WR.ifPn.�CEICLI.1-L'-t.l Gibmn County Auditor 107 N Main � � � � � � � ' � � ' � ' PRINCETON IN 47670 IndiviJuals and ina;riN coupk. arc limilcd io onc home�caJ s�anJaN dMuaion. As ihc rttcipt oi Ihis dNuction bcconres murc bcneficial, thtrc is morr incrnme dun r�er (or homesrcaJ Baud. Home..'reacl :rawl wuses hi�her Iac �ills tor all: thrrtfore. � HEA I.4-1-3IX19 requim uxparen �.'ho reeei.e ihc hanesecaJ sWmlard dnluction tn verify tMt ihry are':IieiMe m reacice ihe ����'"1 � benefi� am1 to prtw'idc aiWitiunal idemiiyinc m(om�anon �cr.an� ia allw� ewn:�� ro�rmment ro b:nrr mmiror humesrcad � � tilin�n-. This infnrmitinn xiil h Aqv mnliJrniial anJ r.in nnly M arer..nl hy� amfar'ved cnunry� n17civi;.'ITe Ikpanmem o( �� I.ceal Gorcmmem Piwnt< �vill u.e this infoemanon ro cream hql.. ihat �vill h;lp c�wnry u(ficials dimmarc homesuad trauJ. MAY 5 2010 �� �David L / Lisa A Sinkhom 867 S Deer Haven Dr Princeton IN 47670-8854 — I�I��II���I�II��I���III���I��I�I��I��I �AVID IRIIIIIIIIIRIR Tasoarer Name Sinkhorn, David L/ Lisa A �- g Addttv (number and strec[, city, smtc, snd ZIP codc) Q(D% ;cS. � EER f-�.4 V�N /�R � V E $ocial $ccuri�}' Numbc� (last i digits) Driver's Littnse/51a1e ID Nwnber (Itit 5 digils) � � L� S� I �. iline .Address (Number and syreel, citp, smie, and "LIP cak) � �� S. �E�� N� �� �R� �� :ial5tturity Numbcr �laa 5 digics) Dm�ds LicensdSWte ID Numbcr (la,� 5 digits) ,� � R? Dox �53< �nccton I�'47670 , � i S[ate Parcel Number Leaal Descriiition 2612-15-100-000.097-02�0o�00os7-oo PT Nw 15-2-10 2.613 AC ai j �Inl KHo�nl mpmperrvaddres __'._. _.... 7 i Oihcr (pleazt speciF in Part 4 below) cs%N K �oR � � Same as pmpeny addn>; Othcr (plcasc spccify in Part 4 Mlow�) undersigned certifies, undzr penalty of pequr}•, that the above and (oregoing infortnation is we anJ corrzct and that he or slie is eligible to :e the homesiead standard deduction on this property. Each undersigned also understands tha� by claimine additional homestead deductions ,fiylly, he or she may be li�ble (or back taxes and substantial financial penalties. i �-7-i c� (