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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION .
Sute Fwm 5473 (R2 / S92)
INSTRUCTIONS: See reverse side 1or filing instructions.
FORM
HC10
YEAR
� CERTIF�C N STATEMENT
I(We) t� he y a,79_
I(VJe) occupied as our principal place of residence follo i descri d al property for which a omest ro i is hereby claimed:
❑ I(We) owned ❑ Are buying under con ract � � ��� ���n
❑ Have a beneficial interest in the entiry that is liable for the property tazes on the property and that owns the b ��under a contract.
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" CONTRACT RECORDED ` j
If buying on contraa, Fee Simple owners name GILSO�� �'�� ��' �' '
Recortler's oNice where contract is recorCed Record number Pa9e
PROPERTY DESCRIPTION
Counry Township � Ta�dng district (ciry, rown, township) -
P cel number Legal destription
� - i - � �s-a-� �
If any ponion of the resitlen6a15WCWre or the WrW not exceed� g one (1) aue ihat immetlia ey surtounds ihat suucture is used lo produce inco e. tlescnbe Ne use and poNon of
the property uGlized to protluce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Caunry Township Counry Township
ure f ai m
areby ceAify the above statements are true, correct and complete.
Ad e( nymber nd streeC ciry. s te, lP cade)
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ASSESSOR USE NLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding i(one) acre immediatety (��
surrounding residential improvements.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4) ..
fiesidential improvements
Garage (5)
Other improvements (6)
Total improvemenis (line 4 through line 6) (7)
Tofal value (line 3 plus line 7) (8)
I hereby certity the above is true, covect, and Signature of Assesor Da�e signed
compiete.
Verityinq action - Signamre of Autlitor Date signed
• STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead S
Valuation or 52,000
Signature of Autlitor Date signetl
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
1372
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mr.�suux wnv au
YAFV AI�1ffl pY TIf �EPMMtVi(f L(M'At CA1�iL�'MfM iPP�CE IC41.I�L'-�.1
InJiciJuaL anJ rtu;riN roupk> arc limiied io orc home�eaJ �tandaN JNuniun. As ihe tttript of ihu Aeductbn 6ecomes
mure brneficial. �here is marc incrnmr than ear (or homesrcaJ fr�w1 Iloma�ead imud ca� highrr im 6ills for all: ihr¢far.
HEA 131i-?q(19 requvcs u�paycn aho rcccirc ihc hanestead standarJ dnluc�ion m.eri1y thai �hry am diciSle to recei•c �h.
benent an1 ro pnxide a4litional iJentiirinc infurmauon neca�vry io allw� counry� gcn�rmmrn� tu Ntrcr muniror homcsrcaA
filin��.'Ihis infnrmmion x�ill hr Aqx conlidrn�inl and can only h: arcrc¢d by aulMriuvl rnunry o�iciaL.'1'h[ Ikpanndm� o(
Lucal Gw<mmcN Fi�u'rcc ��ill u.c this infurtnaziun m crcam muls Jut mill hcln counn� official. climi(urc homesmad frauJ.
Allen L/ Jan M Byrns
5181 W 100 N
Princeton IN 4767a8407
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T•rzparer Name
Byrns, Allen L/ Jan M
State Parcel Number
26-11-OS-300-004.012-027
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SISI N' 100\ 1�
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Princeion I\ i7670
Leeal Descripiion
006-04012-00 PT NE SW 5 2 11 .50 AC
D-1-78
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$auril}' Number (las 5 digiu) Drivers Licen�rl5ia¢ ID Number Qut 5 digiL) O�her (pleasc spaify in Pan 4 below')
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.4ddrtss (NUmber and riree4 di)', sta�e, nnd ZIP cale)
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1-1 c�.,,,e u pfoperty adJto
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spccify in Part <bebw)
undersigned certifies, under penalty of perjury, that the abo��e and (oregoing infortnation is we and cortect and that he or she is elicible to
;e the homestead standard deduction on this property. Each undersiened al>o understands that, by claimine additional homestead deductions
rfully, he or she may be liable (or back taxes and substantial financial penalties.
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