Homestead_Day (5)„..,.,,
eE � CLAIM FOR HOMESTEAD PROPERTY TAX
i��� CREDIT/STANDARD DEDUCTION
State Form Sa73 (R2 / 5-92)
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INSTRUCTIONS: See reverse side for liling instructions.
, � . ., . . . �� rFOnc�reni
FORM
� HC10
YEAR
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�We H L J � �CJ that on the 1st day ot March, 19
�—� ,--
a ied as our princiPal place of residence ihe follo� ing described real propeny for which a Homeste erty Tax Credit is hereby claimed:
�1 I(We) owned ❑ Are buying under contraci . - �
❑ Have a beneficial interesi in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
�
If buying on contrect, Fee Simple owner's name
Recordefs oRice where wniract is recorded
--0ONTRACT RE(
number
” PROPERTY DES I ON - ^""•• �• `
Counry . ' TownSNp • � T� di �� �i 10 owns ip).'� ' '
-c � u er ����� Lgc,altlescription , ,
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It any ponion of Ne resitlen;ial strucwre or Ne land noi exceeding one (7) aae that immediatety wnounds ihat strucNre is used to produce ixome, describe the use and portion
a Ne propeny utilizetl ro protluce incame.
�ilp- f �- 0� -303 a6�
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
;ounty TownShip Counry
�'jy certify the above siatements are true, correct and complete. Signamre ot �aimam
Address (numberandstreeG ury, sfate, ZlPcode)
ASSESSOR USE ONLY
Land not exceeding 7(one) acre immediately
surrounding resideniial improvements.
Other land
Total land (line 7 plus line �
Dwelling
Residentiai improvemenis
Garage
Oiher improvements
Total improvements (line 4 through lina �
Total value (line 3 p�s line 7� �
I hereby cenify ihe above is irue, correci, and
complete.
swirg action - Sgnature of Audimr
19_Pay79_
Lesser ot 1l2 Homestead
Valuation or 52.000
(�)
l2)
(3)
(4)
(5)
(6)
(�)
(8)
TRUETAX I ASSESSED
VALUE VALUE
ofAS5e5sor
STANDARD DEDUCTION ALLOWANCE
5
HOMESTEAD
VALUE
�•�
NON-RESIDENTIAL
VALUE
Date signed
Date signetl
�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
2906
�urerrn�u
nt�suRUroav:su
Individua6 and ma:riN couple. are IimiieJ io orc hnmevnJ 9andanl Jtduction. As thc rttrip� ol this deJuaion bc�rnxo
morc beneficial. �herc i. mwr incen[oe dun e�er (or homnrcacl (rdud. I lomeread f`aud causcs hi�her tas bills for all: thertfae.
HEA 13ii-'_IX!9 requ'vn mxpa�crs v:ho r.�cei.e ihc hanesiced standird JcJunion �u .crily ihat �hey vc clicidc io mcei.r �6e
benefii anJ to p�a'iJe aJJiiional iJrneiiyirc� in(urnCnion �hcr.an• to allw' eWnn' gwrmmenl ro W.ircr mmiior Iwnu�e:xl�
tilim�,n. Ilus iNmma�ion will 6r Acp eonfdrntial anJ can nnlp R arec.¢A b; amhnriid mnmy n(Ticialx. TAe Ikryunnunl of
lucal Gm�cmmcnt Fivm'c ��ill u.c this intorma[iun w arcau hols ihm aill h:lp �vunn� ufficiaLs climiwm humcWCaJ iraud.
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Abu Hussein Lorinda
302 W Mulberry
PrincetonlN 47670-2344
���u��iu�i��u��n���uni����i����������i����i�in�i�ui���
T•rxoarer Name
n, Lorinda
�
Prnpert�• Address
30? W plultx�m�
I'rinccton IN 47670
State Parcel NumAer Leeal Description
26-12-07-303-002.363-028 01s-o2363-0o HALLS 2ND 23PTn4 PT
1 1
Owner I • First M11idN< A Lazt
L,O� �nd0. Av�/1 I'WJ -NJSSe� �'1
--' �:gAddr-,s; (r.mr.b..-rm:d�stra:-ci:j: statc; cnd ZIP code) — — — '— . . - - —' _- ' � 5=•.^.c ss prvpcm.uddres;-- _ _ - - —_ _
. Oa �( Molbe.rr� 5�- �rin�,ivh IN y7Co' b
$ociai Sceuriry Numbn (las� 5 dieiu) Driver's LicemdSiate IU Nmnbcr Qu� 5 digiU) Otha (plesse specif in Part 4 bclow)
S�wu;c First MiJdlc Lyt
N /A
Mailin, Addrrss (Number and stree4 nq'. smie, and "LIP cuJe) � S:une xi pmprrty udJrcai
Social Sccuriry Numbcr (last 5 diei[s) Drivcrs Liccnsr/Statc ID Nwnbcr (last 5 digits) Othcr �plcasc spccify in Part 4 bclow)
sex
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Fach undersitmed cerrifies, under penalry of perjury, that the above and foregoing infortnatiun is we and wrrect and that he or she is elicible ro
receive the homes�ead standard deduction on this property. Each undersigned al;o undersiands that, by claiming addiiional homescead deductions
unlawfully, he or she may be liable (vr back taxes and substantial financial penahies.
Owner I SignaUrc / �/ Uate
S�wux Sivu�ure Uatr � Tcicphonc
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