HomeMy WebLinkAboutHomestead_FugatewRn+ xc �o �ern
PrescriDeC By Sute BoarE ol Tae Cammissioners
To & FiIM in Wplicate
CLAIM FOA HOMESTEAD PAOPEATY TAX CREDIT FOH YEAR 19 ��
SEE BACK FOR FILING INSTRUCTIONS
'�(We) �-�-��-� i��� •���• certify that on the 1st day of
arch, 19��, I, (We) occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We).�owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description
Taxing District (Ci4y--�ewr�Township): �� �
Parcel Number
If buying on contract: Owners name ��� simo�e
�j�� - QD�ID
\i�a-iz s.� Township
or legal description shown on tax statement:
� So A
��F./UE %f �-z-io�S•ISA�
Contract recorded in Recorders Office - Record
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
Any other counties in which individual owns or is buying real property:
�hereby certify the above statement is true, correct and complete.
�� ���-� � � �`3 x
Aaaress
County
Township
�Z�
Ciry. State ena Ziv CoEe
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer. -
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1(one) acre immediately
surrounding residential impro� e� �
Other Land � �
�
Total Land
Residential Improvements!,j:j 2 ; �a��
Dwelling
L��-�'-eI�X�'� Garage
�� �
Total
Other Improvemenis AUDITOR
T� Improvements - Line (6) plus (7) equals (8)
I�by certify the above is true. correct. and complete.
Signamre al Asseswr �� v'
True Cash
Value
( � ) .5 z-o
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(3) S 2-0
(4) /�i90
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(6) / .Z `f S o
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Homestead
Valuation
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Date: T/ZG/�%G��_
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
6�diriduals anJ �rtvriN aoupks arc IimiieJ �o onc home.tead sandaN 4^Aunion. Ay �he mceip� ol ihis �JNuninn bccome�
merc beneficial, thrre is morc incen[n'e dun rccr (or homcsmaei fnud. Homesrcad $auJ cauxs hi�M t�c bills fur all: there(ore.
HEA 1?d-i-?009 requ"vn �a�pa.en who r.-ceive ihc hanesicad siandard dnluction w.erily �hat tM1e} are el eiWe io rtcci.e �hc
benefi� amf io p�w'id<:ukiiuonal idemfirinc mturmarion nemvn io allw� counrv ginemmrni ro Mtrcr�muniror humesttaJ
filin��_'Ihis imnrmaGon will M AryM mnlidcnliil and can nnly M� arcesml hy authnriied rom�ty n(ficial�.i fhr Ikpannreni of
I.ocal Gm<nvnem fi�uMC ��ill u.e this infomueiun w crcaee ¢+ub �ha� �rill h:in aro�mn� WTirial. eiiminatr hunat<ad fiaud.
2200
Charles N/ Anita E Fugate
1240 N Cariihers Rd
Princeton IN 47670-8651
I�I��II���LII��I���III���LJ��IL,�I�L���II�LJIL����I�II_ , _
I cQi'
�L;ts: ci:�, s•at:. ond ZIP ca',)
/ �Q%'//i"1 -C.'/—
3si i digits) Drivds Licenx/Siatc
I ��
axreeL ciq', slate, and ZIP wik)
Ta�pa��er Name Prnoem• Addreas
i
Fugate. Charles N/ Anita E �
� R313ox I7 Q�
o<
� 1'rincewn I� 47670
�
Sta[e Parcel Number Leeal Descriotion
26-12-OS-200-000.610-027 005-oo67a-oo PT NE 5 2101.045 AC
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--.�es om !rv e�JdrS=
(Imt 5 digib) � Oihcr (pleasc sptciF in Pan 4 yrlax�)
5 digits) � Drivcrs Liccnsc/Statc ID Niunber (last 5 digits) � Uthcr (plcasc
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�
Pan 4
�r �
rv addros
undersigned certifies, under penalty of perjury•, that the above and foregoing infortna[ion is true and corrzct and that he or she is eligible to
�e the homestead standard deduction on this propeny. Each undersicned al;o understands that, by claiming addilional homestead deductions
rfully, he or she may be liable for hack taxes and substantial financial penalties. �
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