Homestead_Bloebaumt; CLAIM FOR HOMESTEAD PROPERTY TAX , - f�
`�`�CREDIT/STANDARDDEDUCTION ' . . `n�el
t � SI:MFwm�73(R6/4-03) �
Prescti0cvl by tne Deoartment ol Local Govemment Rnancc �-� ' - '
INSTRUCTIONS: See reve�sr sidc !oi liliny msbui;tiunti. • . ,� .-
FORM YEAR
HC10
.. '
�(We� %�'Yl.(�x�%�� ����" a� 1 n P ba k m certify Ihat°� ty-h� 1st da of arch, 20_
I(We) occupied as our principal place of residence Ihe follovring described real property for which a Homestead Propeity T�r reby Gaimed:
❑ I(We) owned ❑ Are buying under contracl - � ^�` ^' "` '"-" n i IpITOR
` Have a beneficial interest in the enlity ihal is liable for the properry taxes on the property and that owns the pmperty or is buying under a conVact.
I( buying on contrad, fce Simde ownefs name
Couny
i��mi
ai ihe ProOP+�Y �'�
where contrad is reoorded
Toxnship
.iz51*.: °_'f'- �+� . '
Retord number Page
;�_.. = z.,1;�?� ..�}` � - +�.
town, township) - -
3ry1-1 -���� `�(/�,O I Is t�e property in question:
Y ❑ Real ro
�) P U�M ❑ M11cUile Homo (I.Q 61J-7)
uCential struCure w the lana nol exceeding one (1) acre tAal im diatey wrtounds that sWCture 4s used tn produce income, describe Ne use antl portion
m produce i�xome. . I. � L ���
a�- � a - a-, - �6a -
�
_
,:?.f"sr.a..'_-:?f.';.n + .-<`�'' �:-'^i�..�"-�";t>z:P,ROPERTY,OWNED'BYCLAIMANTiI �OTHER`COUNTIES �i:�_-Y �,�'iE��"+�-."a"�. ��-'. ��� ��.�.....
Counly , Tvxnship ' Coun Tavnship
I h eby certi(y the above statemenls are true, cortect and complele. 9 mre o( Gaimant
� dress (number nnd stieeL cip; slafe, Z/P code �
doX—1 � 9
��.-?�'�"" �r ��' ;` �" �''��x�'3Y'�sz �`��� +�TRUEeTAX � � ASSESSED VALUE � HOMESTEAD' . '�}r t NON;RESIDENTIAL'� � �
4:r,.�`s �fyJ`ASSESSORUSE�ONLY�4���1����,,,�.{VALUE �s.�"�.AT100%.OFTTV���tVALUE�' �F�A!/��"'r:f.VALUE�'.��r�n,�„
F� ��. �r
Land not exceeding 1(one) aae immediately . ��Ja".�,y.,.:���"" f�t-d' �-�`:�
surcounding residential improvements. . (�) ;"-'c°� r�.�,�, ti a; ;�`� ���
Other land �2) � i�-, 3� � '`"tt�''i'+f, v - - -
i �-. '�
x..�; �W �.+'.�,�'-_ � x
TUai land (line 1 plus line 2) (g�
� : �S- ti : �
Dwelling (4) �;'t si��, � � �`�;'.:R-� �� y� ��'-5.
Residenlial improvemenes ar Annually ',# ��,�, h�¢��� 5�, �,
0.ssassed Mobila / Manufacbued Home Garage (5) f alTr'Yr��'-_'�'�s-�?�=' :�s�_�',.'_��°�r:
s. -: ��r �w'i
Other improvements (6) '�- � ;,_��-`�.
�
Tdal improvements (line 4 througb line 6) (��
Ttial value (line 3 ptrs Irne n (g)
I hereby certify Ihe above is We, carrecl, and Signadre of nssess« Da�e sgned
complete.
Veri(ying action - Signawre oftwditar Date signed
c \ SLqEfORM!JwpC/w0 M.WAGPo0.V:SIA
.V�RITFl1BTS!\TEBIHR➢OfN�T�.\'I�9v ��.GS(ROmBYiIQUVART(FYi((L(A'ALCM^e�VMfA'TiQ.'n\I'F.If'sll.!'JI
Gibson County Auditor
101 N Main
PRINCETON IN 47670
InJiviJuaL. anJ marrinl couples are limi�ed �o onc homeweaJ �andaN deJunion. As �ht �aeipi of ihis dcduction becomc
more beneficial, therc is morc incenm�e than rer (or homesieaJ fr�ud Ilomn�ead faud cau.ses higher tac bills iur all; therefore.
HEA 13�i-3IX19 requ'ucs mapayen Mho �eceire Ihc hancstcaJ standarJ JNuction iu verify ihai iAcy are cliciMe io recei.e �h.
benefit anJ lo p�m�idc adUitio�ul idrnmrin_ inWrmutiun �cn'vry to allou� crounry emrmment to bener muni�or homesttaJ
filint�. This inlorma�ion aill he Aryw mnfiucmial and e5n nnly Fa acrexarl b�� amhoriznl rnunry nlicial�.'Ihe Ikpanment of
Lucal Gm<mnrcm Fifu�rce �vill u.c this in:ofmation to arca:e twls dwt �rill h:Ip aputty ufficials eliminme homeslwJ fraud.
1645
Sharla K Hiatl
2535 S 350 E
PRINCETON IN 47670-8806
�i�u��in�i��n�u�����n�n�i�n����in���ini��n�i�n��n�
Taspa��er Name
Hiatt, Sharla K
�
Prnpem� Address
?i3i S 350I:
1'rinc�ton IN J7670
State Parcel Number Leeal Descriotion
2612-27-200-003.819-027 OOCr03819-00 PT E NE 27-2-10 1.998 AC
� D-10
This form MUST be retumed to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
�•
Owner 1 First MidNe Lut
S � d� ��
�ig Addmss (number m�d'>ucet, ciry, smte, end ZIP code) . �✓�'$nme ns prapem nddjev
as3 s_ `3 �_ ��-� .� � �-� �
Social Securit}'
Middlc Last
Mailine Address (Number and srrcct, ciiy, suic. and ZIP cale) � Same:u ptopem addres
Social Sxuriry Number (last 5 digits) Drivcrs Licrnsc/Stacc ID Nwnbcr (la,t 5 digits) Othcr (plcscc spccify in Pan: Mlow�)
sar
_ �
Each undersit,med certifies, under penalty of perjury, that the above and foregoina information is tme and correct and that he or she is elieible to
receive the homesiead standard deduction on this property. Each undersiened also understands that, by claimin¢ additional homestead deductions
unlawfully, he or she may be liable for back ta�ces and substantial financial penalties.
Owner 1 Sienanse IMtc Telephonc
' c_{� `F�t� ��
Spouse Si�amre ��� Telephone
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1 � � ' �