Homestead_Cutsinger.� rt.n
, � CLAIM FOR HOMESTEAD PROPERTY TAX
� CREDIT/STANDARD DEDUCTION
� � State Fam 5473 (RS / 10-01)
Prescribed by Ihe Department ot Local Govemment Finance
INSTRUCTIONS: See reverse side /or �ling instruc�ions.
FORM
HC10
,
YEAR
I(We) l � �i'" /(, (/ ceNfy n th�q 1 of March, 20
I(VJe) occupied as our principal place of sidence the following described re roperty for which a Homesiead �rty T# �s hereby daimed:
❑ i(We) owned ❑ Are buyin nder conlract ��`�% %� /�/7
�-lave a benefidal interest fn the en6ty Nat is liable for the property taxes on the property and that o�e,pfope,`�S j� y�Ybp.yinqAWlg�conVaU.
If byvg om m�uad. Fee Simple owners name
RecoNefs otfice where conVacl is remrded
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Counry Tamship
(Clf};
Rewrd number � Page
�Par I r/��/ Legal 0escription � Is ihe property i question:
� (�j'(p�� � Q� �Real DroPerty ❑ Mobila Homo (I.Q 61.1-7)
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If any portion o11he residential sW cture w the lantl not axceeding one (7 ) acre that immediatety surrounds that swGUre is used to produce income, describe the use and portion
at the properry utilaed m produce incoma.
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���ti�%�m� �"`.,3��n4!^�`�,°�:or..nv7r�.�i'�.STANDARD�OEDUCTION'ALLOWANCE .rs.C�;e�`u�i',,,•�t5,s'`;�,r : ,�_. `•4__*,i���'3��:,.�
20_Pay20_
Lesser of 1/2 Homestead
Valuatlon or $6,000 5
Signature olAUditw Date signed
SiAI?' FORM 51569 �Rl/&10)
_ . � %APPRO�FP9^SiATEBOAR�OFACCOl7�TS.?009 ._ _
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TRFASURE0. FOILN TS-IA
PRFCCRIBFD Bl' i}iE D�^M]1�Y: OF LOCN. CA`.TR.:.:: \T'r'�::.N.`c iCbi.i-Z3-6.1 "
Individuals aod married couples are limited to one homestead standard deduction. As the receipt of this
deduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
«causes hidher tas bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
standard decluction to verify that they are eligible to receive the benefit and to provide additional identifying
information necessary� to allow courity government fo better monitor hortiestead filings. This information
«�ill be kept confideutial and can only be accessed by authorized county offcials. The Department of Local
:- Go��ernmeot Finance will use this information to create tools that will help county officials eliminate
' homestead fraud. '
Taxoarer \ame
David J Cutsinger
Conzp(ete and return to:
fi
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0
Prooertv �ddress
835 S HALL ST
PARJCETON IN 47670
$tate Parcel \umber Leeal Dacriotion:
26-12-I8-101-001.680-028 L E WOODS 14
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GIBSON COUNTY AUDITOR, t01 N MA[N PRINCETON IN 47670
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Senuiry NumEer (last 5 Eigib)
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$df110 85 FlOp¢IFJ 8dM855
(please spevty in PM 0 belav) .
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Sue piher (please speaty in Part 4 pelow)
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Each un^e!s:gnad certifies, untl?r penalty ef penury. that the above antl foreaoing information is [rue an0 cortect antl [hai he o� she is eligible to recerve t
ncr..^< �ard deduction on this property. Each undersigned also understands that, by ciaiming additional homestead dedudions unlawFulty, he or
s may be liati -for back s and substantial financial penalties.
U�ce; 1 S:uaa•ra ' Date Telephorre
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