Fulton County Auditor

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FORM
HC10

Year
INSTRUCTIONS: Click here for filing instructions.
NOTE: Telephone, Social Security, drivers license, state identification and federal identification numbers are confidential under IC 6-1.1-12-37.
CERTIFICATION STATEMENT
I (We) First Name
Last Name
certify that I (we) occupied as my (our) principal place of residence or am (are) buying the following described real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the date this application is signed,
Date of Signature (mm-dd-yyyy)
I (We):
          
Note: Please provide two identification numbers for each person
Name of Claimant (Legal Name)
Phone
Email
Social Security Number of Claimant (last 5 digits)
Drivers License number of Claimant (last 5 digits)
Issuing
State
Other US issued ID number of Claimant (last 5 digits)
Type of ID
Name of Claimants Spouse (legal name)
Phone
Email
Social Security Number of Claimants spouse (last 5 digits)
Drivers License number of Claimant Spouse (last 5 digits)
Issuing
State
Other US issued ID number of Claimant Spouse (last 5 digits)
Type of ID
Contract Recorded
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
County
Township (optional)
Taxing district (city, town, township) (optional)
Parcel number (optional)
Legal description (optional)
Property Location Address
Is the property in question:
    
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion of the property utilized to produce income.

PROPERTY OWNED ELSEWHERE BY CLAIMANT
State, County, and Township (enter N/A if not applicable)
Is claimant vacating a homestead?
Address of Claimant
I hereby certify the above statements are true, correct, and complete.

Signature of claimant
If address of Claimant is different than Property Location Address, please explain.
Verifying action - Signature of Auditor
Date signed (mm-dd-yyyy)
STANDARD DEDUCTION ALLOWANCE - Auditor Use Only
20 ______ pay 20 ______ Lesser of 60% of the assessed value of the homestead or $45,000

Notwithstanding any other provision, the sum of the deductions provided in IC 6-1.1-12 to a mobile home that is not assessed as real property or to a manufactured home that is not assessed as real property may not exceed one-half (1/2) of the assessed value of the mobile home or manufactured home.
$
Signature of Auditor
Date signed (mm-dd-yyyy)
Attach documents if requested by Auditor

DISTRIBUTION: Original - County Auditor, File-Stamped Copy - Taxpayer
Attach Document (PDF, JPG, PNG, GIF, TIFF Only)
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