Homestead_Deckard�E R„
1 4 CLAIM FOR HOMESTEAD PROPERTY TAX
si�= CREDITISTANDARD DEDUCTION
�:;;I� State Porm 5473 (R2 / 5-92)
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INSTRUCTIONS: See reverse side tor liling instructions.
FORM
HC10
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YEAR
K �/ �[r L � lyy/
.� (we) d' _. _ �( - �___ certify that on the 7 st day of March, 19_
�) occu as our principal place o( residenc i e o. o n described real.pmperty for which a Ho tead Prope T redit is re Gaimed:
I (We) owned ❑ Are buying under contraci , ;.
GI8/��7 ' F!J�ITO�
❑ Have a beneficial inierest in ihe entiiy ihai is liable for the property taxes on the property and that owns the property or is buying un er a contract.
� CONTRACT RECORDED - � - �
If buying on contract, Pee Simple owner's name ,• , . �
Recorder'S oHice where Con(ract is recorded Record number Page
County
Parcel number
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PROPERTY DESCRIPTION
. . � Township T�ing tlistrict (city, fown, township) _�
Legal description �
� �D"� -C� �' �r' o
t ihe residential sVUCture or ihe land noi exceeding one (1) aae [hat immediately surrounds that strucNre is used to
utiiized to ptoduce income.
irxome, describe ihe use and ponion
- PROPERTV OWNED BY CLAIMANT IN OTHER COUNTIES
County Township Counry Townshi
�'eby Certify the above Statemenis are true, correct and complete. Signat of cl �mant �
Address (number and slreet. dry. stale. Z1P code) ' � 1
O I "�./
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL.
. VALUE VALUE VALUE VALUE
Land not exceedinq 1(one) acre immediately
surrounding residential improvemenis. (�)
Oiherland (p) �
Total land (line 7 p/us line Z� (3) .
Dwelling (4)
Residential improvemenis
Garage (g)
Other improvemenis (6)
Total improvements (line 4 thiough line � (7)
Total value (line 3 p6s line 7� (g) -
I hereby ceRify the above is trUe, correct, and Signa;ure ot Assesmr Da,e signed
complete.
Verifying action - Signature of Audimr Dare signed
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STANDARD DEDUCTION ALLOWANCE
19_Pay19_
Lesser of t/2 Homesiead
Valuation or 52.000 S
SgnaW re ot Auditor Dare signetl
r,
L J
Gibson County Audilor
101 N Main
PRINCETON IN 47670
643
STi1E fOAM �iKIR�/ f WI
1RF.151�1iA PoRV:1:�
InJieiJuaL. and inarrieJ muples arc limitc-0 �o nnc hnmcucaJ �andaN J.vlunion. As Nc �ttrip� ol Nis dcxluction becomca
morc bcneficial, thrrc is more mcenme tlun e�er for homesteacl fraud Ilon��ead fmud caus6 higher Iac 6ilis for all; therefae.
HEA IS-13-?IXW requim u�papm xho �eceive thc hanesreaJ smndvd dtttuction w rerifi� dut they am clieide to mcenr ihe
benefit an1 ro p�w'idr aiWitional identifcmc in(urm�twn necr.'vn� ro allou� ewnrc gmttnmeni �o bever mmitor Iwmesttad
hlimc�. This inlarrtutiw x'i0 be F:epl cmGdemial anA aan nnly M aroec�ed 6}' authnriud row�q nRcialz'ILe Depanmm� of
Lucal Gm'<mmrn� FinaM< ��511 u< this iniortnation W cr<atc [wls �hat mfll hclp cvunm offxiaLs diminatc Irom<wcaJ fiaud.
. • ' , , , .
Taxpa��er Name P�npertc Address
Deckard, John R/ Peggy L
John R/ Peggy L Deckard
601 Govemor
PrincetonlN 47670-2849
I�I��II���I�II��I���III�����I�II��I��I��II�I��II,�����II��I�II
601 Go�'cmar
1'rinccton W 37670
State Parcel Number Leeal Description
J(2Cr12-1&103-004.00Q028 0lsvaooaooMCtc,4WSUMMIT24
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O�.�utt 1 First MiaNc �au
�oh�, {:. �ECka rd
�e.Address (mimbcr wd itmt, rity, seate, and ZIP code) � '-- —' —'-' �Snrtrc n+p�upcny uLLia;— ---
� IoDI GovERNo/� �I'�NGEEoni� ��• 476��
$ocial
Spou;e First Middlc Last
I�E6Gy �, �E�I:ard
Mailing Address (t�umber and strze4 �q'. siate, nnJ "LIP cak) �Same a5 pmperty addre�s
(�DI GoVtRN�R �Y�N���ol✓ �Tn/ �7(o7D
Social Stturiq� Numbcr (Iazt 5 digits) Drivcrs Liccnsc/5�atc ID �wnbcr (lan 5 digics) Othcr (plcasc spccify in Part: Rlow)
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Each undersigned certifies, und:r penalty o( perjuq�, that the above and foregoing information is we and cotrec[ and that he or she is elieible to
receive the homesiead standard deduction o this properly. Each undersiened alio understands that, by claiming addilional homestead deductions
unlaw•fully, he or she may be liable for bac taxes and subsiantial financial penalties.
Ow I Si nue � Date Tdephonc
4-�o-io (
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