Homestead_GreeneFOflM HC 10 1979
P�escriGM By State Boam ol ia+ Lammissfoners
To Be FileE in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19Z
SFF RAC:K FC1R FII IN(; IN
�(We) �^^�-- �-„- �. certify that on the 1st day of
�tarch, 19_2�, I, (We) occupi 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 in .��-�
Taxing District (6tty--iowrr, Township):�
Parcel Number
If buying Ofl contract: Owners name ��� simD�e owneq
6� � -ao6gs
�� Township
or legal description shown on tax statement:
� ae�R�
C�. N uJ �i� .1J uJ ��s� ,�C - i- ii
Contract recorded in Recorders Office - Record No. Page
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:
i hereby certify the above statement is true, correct and complete
� O n _ i _
0. 3
Sneet ntlaress
County
,
Township
Cny. Sa�e ana Lp Goae
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a bene(icial interest.in the taxpayer.
- FOR ASSESSOR'S USE ONLY
Land not exceeding 1(one) acre immediately
surrounding residential improvem$�3 � � � � �
Other Land ��
Total Land
Residential Improvements
Other Improvements
Tr� � Improvements
I�:by certify�he
Sg�u:ure ol
i
�/
�
.�FJL � � �J:J
Dwelling
arag
�� oa
AUDITOR
- Line (6) plus (7) equals (8)
above is true. correct. and complete.
True Cash
Value
(t) 3 �o
(2) —
�s� 3 y�o
(q) o� ��3-0
(5) —
c6) a�f�i-3o
(7) —
(g) ��SL�o
- ACTION BY AUDITOR -
Assessed
Va1��0
�
Homestead
ValuatiorL
�=. -►
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� — / — 7
oa«
Date: —� �i' � �
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si�reroan.�w�tiiw.� ! iwrwsutuwzw�u
.\��Rln'EOBY«�iFM\PDOFY���n\TS.9M �Af9(NBmBYlI1fUFIA0.Mf.YfOftIXALC(T[RYfRT�TiQ:A`�21f.L1.1-L'-il
Gibson Counry Audilor
101NMain '�' � � � 1 "�' ' � '
PRINCETON IN 47670 Iwi��iJ�als aud ma:riN couplcc are limi�ed �o onc hnmeaead eundaN d.lnlu.iion. As Ne receipi oi �hu dedunion bccome�
� ���'�{"� � more bentficial. thrrc is more incen:ne �han e�er (ar home�eacl Rawi Ilomntead fmud cau.� hi�M ta� aills (or all; therefwe.
A � HEA 13�#i-?IX19 require> taxparers x�ho rcceivc ihc hwnes�eaJ standard JNumm� w vcrily tMt they are eli=iNe w mcei.e the
B� benefi� aN ro prtn'iJe aiWitmnal identifrint m(wmatian �xces'vn� ro allow� ooung gm�rmmem ro bn[cr moniror homesea0
filin�. This in(ormaiiw aill br kep contldemial anA nn only h accesseJ br awhnmed counn� oti'mial;. T6e Ikpanmem o(
Lural Gm'ermnem Fi`u�e will ua �his infortnatiun tu crcam twl.a that �rill h:lp cwnn olTictials <limiiu�c Iqmestead frauJ.
APR g Zu�U ' • ' ' ' ' �
_ T•rxp•rrer Name
�7(a ,Q/%" Greene, John H/ Barbare E
— pIBSON C UNTY Uq DITOfl
174 �
John H/ Barbara E Green� i����
R
Princeton
rin"P ceton IN 47670.8311 State Parcel Number Leeal Des
26-0436-100-000.685027 oos-006a5-oo a7
(�I��II���I�II��I���III���I��I���II����II���III���II��I�I��I�I / AC C-7
- - - --- -- -- -�/ . _ --
This form MUST be returned to County Auditor's o�ce.
Please do NOT send this form back with your tax payment to the county
� � vh� I
Address (numbcr ond ircttt, city, sta�e, and ZIP codc)
0
�
�
Cii}', s191e, and ZIP cO11C)
ID Niunbcr (las� 5 digiG) � Other �plcasc
' /r ���J
s
ac pmpcny address
Pan4
� san,� u Propen. aaam;
Pan 4
NW 36 7 7 7 .6887
r.
undersigned certifizs, under penalty of pequry•, that the above and foregoing infortnation is we and correct and that he or she is elieible to
�e the homestead standard deduc�ion on this propeny. Each undersiened al;o undernands that, by claimin¢ additional home;tead deductions
+fully, he or she may be liable (or back taxes and substantial financial penalties. �
1 Sienanve Uav^ Tdeohonc �
y-s�-�o � (
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