Homestead_Carter (3)n.
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (RB / {-03j
Prescribed by the Departmem ol Lacal Govemmenl Finance
INSTRUCTIONS: See reverse side /or liling insWClions.
FORM
HC10
_ i _ _ .
YEAR
'� �I
��e) - ceAity Ihal on.the 1st day of March, 20
I(We) occupied as our principal place residence Ihe following described real prope or which a Homestead Property Tac Credit is heretiy daimeA: n
� (We) owned ❑ Are buying under contract � �'G`""'-`� �J'��`�"'-E?{- �
„�oSC" C:... .
iHave a benefidal interest in the entlry that is liable for the property taxes on Ne properry and that owns lhe property or is buying under a conUact.
11 buying om m�iraq, Fee Simple owners nama
oftice where conVacl is recorded
Counry
O�r I
u any poNw� o�
otthe properryi
Tamsn�v
Legal
(ciQ% town.
` I Is Ne property in
.J fTIII
eW cWre w the land not exceedinp one (1) aca itiet immetliately surrounds
ice i�ome.
Toxnship
I hereby certify the above statemants are W e, corted and complete.
Adtl�eu (numbar and aheet, city, atate,
daimant
Record number � Paqe
woo�m� LJ Modle Homo p.G. 61.7-n
used b produce income, desm6e Me uee and portbn
� 'x-^ a'f'��� ":-"�"�?.'�r��� ��,`t�'�s�'r�"�S4-. � TRUE�'TAX�.� :ASSE D ALIE �HOMESSEAD��'� NON-RE8(DENTIAL,�.c�7�
�, RiUSEONLYN �� �^�,�x1`+L"' , i��wVALUE �"'.�A,T�100'k'OF�17Y , z��V�E �e �i��;3.:xYALUE�� t;t'�",r��%i:-
_ . +t _ � ...dsr-s ��'=.::ci"�"'�+�h�s`�. ..� '- ��ct: c .� ���
Land not exceeding 1 (one) acre immediately �I �y�"�u ��. ,,y ,+;r�.�yr � �'
suvounding residential improvements. � ;,r i' • ;; � �-�%� "�`r�'�
i ) "d,�.`� rvy�'.r}.��`3'..�e:< �.. � i?'_ . � ;
��,�.��;....�q�y� � � .
Other land -
(2) ��6�y,`'."H°.'y7i,�
Tdal land (Gne 7 plus line 2) (3�
�• c� �.i�Cr,rEr�-�--'�-• .. �:
Dwelling (4) H� � .� a_ ,-�� a��.i j,#`�
Residential Improvements or Annualiy '���"'� '�'8�^"`-�'''i°r'f�"�'�'�`�
Asse�ed AAobNe / MarndatL�red Hane Garege �5) �$�Yy.�!; ��y���-.+",�.4�
is4✓I.y.TT:�lw��i..� n�Y�Pi. �
Other improvements (6) }'^`� `:-' ��f."S`-�'=
.` �r �,^.:. a.= _y'.
Taal improvements (line 4 through Itiie 6) (�)
Tqal value (line 3 phs line � (g)
I hereby cBNfy tha above is W e, Corred, and Signature otAssessar Date signed
complete.
Verilyin8 action - SignaWre aflwdiWr Date signeE
20 _ Pay 20 _
Lesser of 12 Homestead
vauanm a E35.000
S
Gibson County Auditor
101 N Main
PRINCETON IN 47670
�'
3868
���
IndividuaL. anJ macriN coupies arc Iimi�cJ to orc home�eaJ �andaN dctlu.�ion. As �he rcccipt al �his deduction heconrc�
morc beneficial, there is more incrnti�x Ihan e�er for homnmad frauJ. I lomesread fraW causes higM Ia� bills (or all: thercfwe.
HEA 13i3-?009 reqvun u�payen who r.crire the hanestmJ smndard deJuoion �o verify tlut tM1cy am elieiWe io rttei�r the
benePo anl m pruride additiunal identii�in_ inform��mn Mce.vn� to allw' cwnrv ga'emmm� �o bener muniror homrsrcaJ
filinb�.'Ihis in(nrma�ion x�ill M Aery mnfidrniial and can only I+e amez.ed b. amMri�cd cnunry nlTicial..'ILr lkpanmrni af
I.ocal Gmammem Pi�uMC eill uw this iniormation m crcau 0.ols �ha� wiil h:ip camrc uf�iciaL. diminam hom<st<aJ iraud.
.,' ,, ,
Taxpacer Name Prnpertv Address
Carter, Robin URickey A _ �- - - - —
_ � ' I??3 S Gibson ST
1'rinccton I\ d7670
Robin L Carter
1223 S Gibson St
Princeton IN 476703003
I�I��II���I�II��I���III�����II�II���II�����II���I�I��II��I�I�I
�n � r
I�ob��,n
'ig Address (number end >trcct, i
aa3 s. q, _
ial Sccurily Numbcr (last 5 dicib)
State Parcel Number Leaal Descriotion
X 26-12-18-203-001.333-028 01s-a7333-0o SS ADD 75
r�rst A71a�le �������
�ynn
siatc, and ZI P codc) �umc ns pmpcm ndd�¢.
an
Ihiver's Licenx/5utc ID Nmnber (la.t 5 digiB) Oth<r (pleue specify in Pan 4 bclow)
/
Addresti (Numper nnd stme4 ��q'. sWie, anJ "LIP cexle)
Stturity Number (lac� 5 digits) Drivcrs Li�
� �
:u pmpeny addres,
5 digi�s) � OtM1cr (plcsc spccif�� in Pan 1 bclow)
idersismed certifies, under penalty of perjury•, that the abovz xnd foregoing infurtnation is tme and correct and that he or she is elieible to
the homestead standard deduclion on this property. Each undersicned al>o unders�ands lhat, by claimine additional homestead deductions
�Ily, he orshe may be liable (or back taxcs and substantial financial penalties.
Sienatur< -� Date . TcleDhonc
,��,�.. , c� n „ � �-,� � � ,,,���,� � ���� - — - - -
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