Homestead_Smith (21)CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
` State Fortn 5d73 (R8 ! 7-07)
,. � Prescribed by 1ha DepaNnent d Local Govemment Finance
INS7RUCTIONS: See reoerse side lor fili� ins6uctions.
FORM
HC10
�
YEAR
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i(we) �� 1� J rsvl �� � DECcertify thal on the 1 st day of March, 20_
I(We) oxupied asbtr pnnapal place of residence the following described real property for which a H�o�m,yey)stead Pm� Tac Credit is hereby daimed:
�(We) owned ❑ Are buying under contraU U�` N R
r�(1NTY AUDITO
��' lave a benefidal interest in the entity ihat is liable for fhe property taxes on the propeAy an�sm'e o or is bu � under a contraG.
Pr PenY Y�^9
If drymg on cmUaq, Fee Simqe wnefa name
Recordere olfice whera conVaa is recorded
Caunty Tavnship
Parcd number /� /� LegaldescripUOn
� ln� I � � I �� ' l� ( J ( J - /i � .
K 2l1)' POIIIOfI OiIhBlBSId8f1(�3� bi(1141Ll8 O! Ih8ldfld l101 GCBBdll19 OIIB �7) dCfB
dlhe Woperty uli6zetl tu Croduce incane.
Taring
Is Ihe
wrmunds
Record number I Page
�m QtleSlion:
eal pmperty ❑ Mobile Fbme (IC 61.7-7)
sUUCture is used to pmduce income, dewiba the use and portion
�_ � � � .� • �
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LarM not ex�rg 7(orre) acre immediatey ..5: `--- :: -
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wrtounding2sidentialimprovemenfs. `;'�;=;���' �
F fzF y
OUterlarW �p� sF-� �;: _
t. �r ,.
Tdal Wnd (line 1 plus I'me � (g�
Residential imprwements a Mnuaiy �elling (q) j= .' c ;; ��'. �
Assessed Mobile I ManuFacWred Home -•. '?.� - '
Ga2ge (g� ,. � -
r -'' 1
Other improvements (6) �=-;p . '
TUaI improvemenis (fine 4 th/ough Gne 6) ���
TUaI value (line 3 plls Grre 7j �g�
I h2fEby C6ftify thC 8bov8 is true, cOrtCCt, 8fW SignaWre of Pssessor Date signed (month, day, yea�
camplete.
Veri(yi� adian - Sipru Wre W Audilw Date signed (month, tlaY Y��)
• �.-� � � � •
� pay 20 _ qs.ppp for 2007 pay 2008 42.000 for 2010 pay 2071
Lesser of 12 qq.ppp for 2008
Homestead ValuaGOn PeY 2009 41,000 for 2071 pay 2012 $
a 43,000 for 2009 pay 2010 40,000 payable after 2072
SigneNre of Audila Date signetl (manfh, daY. Y�
y �� ' ' � SUSEFORMSlNN�0.?/&10) � TIfFASLREA�DLNISIA
.�� • '�S ` wPPPPFDBYSTTEBWIOMA[LDUYISbIN ��-�wmBYT1EUFPARTME�TOFIDGLfA4'EA'MEYli1NA`{£ICbl.l.11il
GibsonCountyAuditor � � � � � � �
101 N. Main SVeet �ndi�iduals and mamed cauples are limited to one homatrad siandard deduc[ion. As the «ceipt of this Jeduction bccomes
Princeton, IN 47670 more beneficial, Jrere is more incenti�e tlw� ncr (or Fwmes�ead (mud Hommead fraud nuces highci ux bills for all; �hcrcfore.
•_ �-�{ �+ �� H �1344-2009 rtyuim taxpa� �wfio receicc thc homestcad sundard deduction ro�xrify [hacty cj are eligiblc tat'� �nc ttce
1 benefi� and to prmidc additional identifying m(ormetion ncccssuy b allox caunty gwemmeui tq bener monitor homestcad
filin Tttis infomtation ui0 bc k t confiMntial and <an onW bc acccssed W author'ved coun ofticials. 7'hc rnt of
Local Gm'emment Finance will vu this infortnation ro awte mols thac will hely munry otTicials �elimi�ute Fromesread fraud
APR 1 3 20�1
C.9.n` --rs—'.�-�-�
v�
, .. GIBSON COUNTY AUDITOR
1887
Clinton J Smith
2191 W 100 S
PRINCETON IN 47670-9315
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TaxpaverName
Smith, Clinton J
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Location Address
i
o,
PRINCETON IN 47670
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I iI0l�iil��ifl �ii �I lii �i�ll �IiII�II�II�Dii�ll�liiii�l�ll �il Ili I��IidIi�IVi�l►►liill
State Parcel Number Leqal Descriotion
26-11-14-300-003.i85-027✓r E sw ia z i� i.nc o-i�
This form MUST be returned to County Auditor's o�ce. '
Please do NOT send this form back with your tax payment to the coun,ty treasurer.
Addxess (numba and street, ciry. statc, and Z[P code)
Sccuriry.
Licensd5ta[c m N�bcc
Address (Number and sueet ciry, state, and 7.IP code)
LicenseJState tD Numbcr
5 digia)
F]
Same es property address
spaify in Pert �; below)
� $amc as Property address
Other (plea5e specify in Part �i bclow)
} _ _ _ —
Fach undersigned certifies, under penalty of perjury, that the above and foregoing infoimation is we and correct and tha[ he or she is eligible to
receive the homestead standard deduction on this properry. Fach undersigned also undecstands that, by claiming addirional�homestead deductions
unlawfully, he or she may be liable for back taxes and substan[ial financial penalties. j
�
SignaRUe Ipy� I�c�epnone � �