Homestead_Stallingse� ��n' i CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
'v 1 Slate Fwm 5473 (RS / 10-01)
Prescribed by the DeOariment ot local Govemment Finance
INSTRUCTIONS: See reverse side lor (ling insWC�ions.
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FORM YEAR -I
HC10
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� certi that on lhe 1st a o are��0
ra
I(VJe) o ied as our pnncipal place of residence the following described real pmpeAy r which a Homestead Property T�c¢r¢� is ev by��l��ijned:
Ul.� � G L
I(We) owned ❑ Are buying under coniract �
`Have a benefidal interest in lhe entity Nat is liable for the pmperty tazes on the pmperty and lhat owns the prope�or is buying yfider a�contracl
If buying on conlract. Fee Simple ownefs name
Recorders office where wntract is recorded
Counry
Tavnship
":CONTRACT'RECORDED,`-:�," � �"'-'-.: r.S�.��_'., - �-��'�:;
Record num6er Pa9e
�'PROBERTY.DESCRIP.TI `it�•:x- - $'.'`'�` � �'�`.`-: -�=�J
Tacing disiric (ci`; 1 m, f� nship) �
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�'+A�'.^�^',��,,•mber (��I)eg scnpti n ) Is ine property in question:
'v �+- O l oa 7� Y ��� I—�— I� �• y�jl�� . eaI pmPerty ❑ A7obile Homo (1.G 67.1-7)
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If any poAion o( tlie resitlentlal sWCtura w the land not excee0ing one (7) aae that immeEiatey surrounds that swcture is used b produce inmme, tlescribe ihe use antl portion
of the property utiizetl m produce income.
: - � --'� ��.: �-^ ' ` -*- - � �....:.pROPERTY OWNED BY CLAIMANT IN
County Twrnship County
I hereby certify the above statements are We, covect and complete. Signat e
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adress (number and s6eet, cdy; s(ale, ZIP codel �— �— �-� ��
� D.. ... � D ... -t'. st a �i ...,. -,� c `7i _: _. _-�.
Land not exceeding 1(one) aue immediately
surrounding residential improvemenis.
Other land
Tdal land (line 1 plus line 2)
Dwelling
Residential improvemenls
Garage
Other impmvements
Ttlat improvements (line 4lhrough Irne 6)
Tdal value (line 3 pl�s line n
1 hereby certify ihe above is We, correct, and
complete. �
Vaifyingaction-SignalureofAudityr �
20 _ Pay 20 _
Lesser of 1!2 Homestead
Yaluation or 56.000 _
Signature of Audnw
�...;;7RUE•TAX� �
��VALUE,;'�__:'
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(Z)
(3)
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(5)
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SignaNre of Asseswr
S
ol claimant
Date signetl
Dale signed
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
1298
Lonnie R Slallings �
1115 W 150 N
PRINCETON IN 47670-8543
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fTARlORA1 �!W Iti/ f�Ml
lPlASUALRPo0.M:Y�A
CMCL4Y.(�'TfY�'�\CFIC61.1-$:-!.I � �
Indi.iJuaL and marriN coupla are limned io nnc hnmc�tead sundaN Acriu_�ion. As the rmtip� ol �his dcduct'an hcomi:
mure brneficial, tMe i> more incenmz than ewr for honxsieael frawL Ilomottad frauA cauus hi�M �a� bills for all: therefae.
HEA I3J-1-]I%19 requirn u<pa�en xho rereive ihe I�nesteed siandaN JeJuciion w.cril'y tlut tM1ry� are eligiMe to recei.e the
benefi� ani ro prtn'iJe addiGonal iJentfirin_ fnturmanon nemsary m aliw� counn gu'emment to Nner monitor honxsrc:d
fili��. Thic i�lnrmation wili be Aryw confiJemial anA esn only le aecr.uJ b�� awhnrimd counn o(ficinL..'I he Ikry�annxnt o(
Laal Gwcmmcm Fiv�rce �cill u�e this intomwtion W crea:e 4vls �hm x'ill hdp cwnry olficiaL+ climinz�e IwmarcaJ (raud.
� � � � � � —
Taxoever Name Pronertc AJdress
Stallings, Lonnie R/Andrea M
Rr3 Bot :2,c
Prinrnon IN �qG70
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/ State Parcel NumAer Le�al Descriplion
t' I I' I' I' I I"' I 26-11-01-100-001.027-02��607027-00 PT N W,1 2 71 2.473 AC
JACKSON PIACE 4lE� D-1 C-7
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Ou�na 1 First Q Afiddle , Lut
L o��i e� I`a Si-�t//� f
•tg AGdress lnumbcr ond �acci; rirv, stere. end ZIP-codej —p ' ' —' - ' ' . . . Sumc ni pwpenr wJr.as- - — � -
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Social
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S�au;c First Middlc � last
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Mailine Address (Number anJ slrce4 ���}', s�aie, unJ "LII' cwk) � Snme:u pm rty addasi �
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Social
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Fach undersitmetl certifies, under penalty of pequry�, that the abovz and (oregoing infonnution is we vnd correct and that he or she is elieible to
recei�•e the homes�ead standard deduction on this propeny. Each undersicned al>o understands that, by claiming addiiional homesiead deductions
unlawfully, he or she may be liable for back taxes and substanhal financial penalties.
Owncr I Siimetwe Dnv^ Tcicphonc
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