Homestead_Deckard�"�'`° CLAIM FOR HOMESTEAD PROPERTY TAX
! : CREDIT/STANDARD DEDUCTION
r State Fortn 5473 (R2 / S92)
.�:,
INSTRUCTIONS: See reverse side lor (ling instructions.
FORM
HC10
YEAR
CE ICATION STAT ENT
1(VJe) i t o the i da of ar , 79_
I(We) occupied as our principal place of residence the follovring described real property tor which a Homesie op rty�r it i h eby aimed:
L
❑ I(We) owned ❑ Are buying under contract
❑ Have a beneficial interest in the entiry ihat is liable for Ne property taxes on the pmperty and that owns the prop�� i�t�in���er a contract.
CONTRACTRECORDED
Ii buying on rnnVact Fee Simple owners name
GIBSON COUNTY AUDITOR
Recorders oHice where contract is recorded � Record number Page
PROPERTY DES RIPT
Cow Township T g Slnct (ciry fowrytqwnship)
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P rcel number L al descnptlo �
O� � � —Oc7 � �
II portion of Ne residential sWaure or Ne tantl not xceeding one (7) acre ihat immediatety sunounds that sWC ure is useE m protluce income, describe ihe use and portion of
ihe property utilized to praduce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES -
Counry TownShip Counry Township
Si nature otclaim ni
.areby certi(y the above statements are true, correct and complete. Q��I ��
tl (number and stree7, ciry, sla7e, ZfP code) �
7oG w. CGii,3 /;�, �✓ sr /i;.rcr to�,, 1.J �/7C 7 U
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VAIUE VALUE VALUE
Land not exceeding t(one) acre immediately �� �
surrounding residential improvements.
Otherland � (2)
Total land Qine 7 plus line 2) (3) �
Dwelling (4)
Residential improvemenis
Ga2ge (5)
Other improvements (6)
TotaPimprovements (line 4 through line 6) (7)
Total value (line 3 plus line 7J (8) -
I hereby certi(y the above is true, correct, and signature of Assesor � Date signed
complete.
Veritying attion - SignaWre of Audimr Date signetl
�J STANDARD DEDUCTION ALLOWANCE
79_ Pay 19 _
Lesser of 1/2 Homestead �
V luation or S2,000 �
Siqn re Auditor Date ' — �
- c' • �LaiEl00.\1!J't+�R'/s�n1 iME15URIAf00.431.�
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� Git`sc\ County Auditor � � � , � 1 � , � , � � , ,
101 N Main
PRINCETON IN 47670 IndniJuals anJ mar�ieJ ooupin are IfmilN �o ore home�eaJ �ta�MaN JNunion. As th< sttipt ol'this Jaduninn bttm�ec
murc beneficfal, thrrr is morc incenme than r�<r (or honmteaJ fnuJ. I lome�eal fatul causes hi�M tax bill� for all: thertfae.
• HEA 1334-21NW requim mxpa�en .rho recci.e ihe hanesieaJ s�andmd JeAunion tn rerilp ihm �hey are eliciNe to rcai�e the
�����benefii ani ro pnr�idr addiiiorol iJentii:�inc in(wmi-iun rccrc'vrv to al-uu� counn� gm'emmenl ro beircr monimr humesrc�rJ
'niim�. -Ifiis inlarmat�w w�ill M Aqv crnEdcrvial and c�n nnh� M aare� d hy aWhar¢n1 rounty ofi�miul+. 7Te IMrannxm nf
Local Gm<rmrcm Fiwnc< ��ill um this in(ortnahon W tt<atc hvls Ilwt will h:Ip cnanro uffieiaL+ climiwte homesteml haud.
APR 1 9 ��»
61880N,COUN��qITb{7
1709
Bret wlliam Deckard
528 W Poplar Ave
PRINCETON IN 47670-2360
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anJ stree4 ciiy, state, and "LIP cak)
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u pmpeny addres�
(la;t 5 digi�s) � OcAcr (plcacc spccif�� in Part: bclow)
undersigned cenifies, under penalry of perjuq�, that the above and foregoing infortnution is we and correct and that he or she is eligible ro
:e the homestead standard deduction on this property. Fach undersi¢ned al>o unders�ands ihat, by claimin¢ addi�ional homestead deductions
,-fully, he or she may be liable for 6ack taxes and substantial financial penalties.
1 Si rc Datc 'I'cicphonc
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