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Homestead_HarySGTE FORH S15E9 (V3l&10) APPRP'E➢B\' STATE BW 0.O i:f3+ii:]�:a� IRFASL"RFR iDAM lSl� RfW�`X£ICbI.L:S$1 � '` �bson County Auditor � � � � � � � � � � �� 1 N. Main Street �- �„a���d�� ,�a married muplcs are limi[ed m one homcttead standald deduaion. As the receipt of Ihis deductlon becomes -- PtIOCEtOO, IN 47670 mure brneficial, iherc is rtrorc incrnti.�e Utan erer Cor homatcad (mud. Homatead frzud cauus highei uz bills for ell; thc¢Core, �� HEA 1344-20(19 requ'vcs uxpayrrs aiw receive �he homestead srandazd deducuon w�crify chac c6cy are eligible to reccn�c [he benefi� and a praidc additioiul idcntif}�ing informnlion necessary,�o allox� county ga�anmrni tc. bencr monicor homesccad T �" filings. 7ttis infortnation will be kept confidencial and can onty be acc�ssed by auUrorizcd county�otiicials. 7'hc Dcparunrnt of � �$.1.«.� � I,ocal Gm�emmrnt Pinantt will use this informazion to crtate tools that will help counrv officiais :limiriate homestead fraud. APR 1 S 2011 — C.J.n� GIBSON COUNTY AUD TOR . . ., 424 . . � . Joseph R/ Cathy L Hary 2052 SW White Church Rd Pnnceton W 47670-9322 ' ����III��"I���II��II�����II�II�I�'�I�I'�II���III�I�I�IIIII�'lll' Taxpaver Name Location Ad�dress � Hary, Joseph R/ Cathy L - ' ' � 2052 SW WHITE CHURCH RD PRINCETON IN 47670 � I II�I�III��III �I� �I �III �I�II �III �I�II�II��II�II�ll�lpll�ll III II �I �II�II�I�I� IIIIIII ,State Parcel Number ° ° Legal D;�scription �_ 26-11-14-100-002.881-027/PTNW14211 1.463AC D-1 f' � This form MUST be returned to County Auditor's office. ; Please do NOT send,this form back with your tax payment to the coun•ty treasurer. Jo � iag Addicss (nwnba �d stree4 city. sta[e, and Z[P code) ao 5 �. � �-= .,�.;,}� ��.�, �... ��. � Sccuriry \�bcr (la5[ � digits) Drivds Limnse/Statc ID t��ber (last 5 - � c�--��y � c` av� �. ecurirv Numbcr (la5t S . I �-�4�� � �� � ��� ��_ Pc..� ���ic�r , S� '�-t b l G t � �s� � � `Z ry ( ` � '—��SameaspropalyaGdriss.��"'�'+..""""'—' l ;ics) � Othu (ptease spexify in Pan 4 bclow) 1 I�V undersigned certifies, under penalty of perjury, that the above and foregoing infortnation is we and correcl and that h�. or she is eligible to �e the homestead standard deducrion on this property. Each undersigned also undecstands that, by claiming additional �iomestead deducrions �fully, he or she may be liable for back taices and substantial financial penal[ies. 1 Sigoatu=e . ' w . , Dam � Telephone . . ' . .. y-�F- � 1 `-4-`i-I� � . .. l,U t 1 I. 1 VI\ li•lSTRUCTIOf•!S I, `,�;e) � � certify t��at on the lst day c� p:_�cl�, i , l, (;ie) eccupie3 as ou� �nc'�oz1 olace ` resider.ce tlie -follc,aing descsi}pd real iJ_'b1,-`=i.y 1�0- �•iP.iC!i d 1�✓r"ii�?Si°,� !�LU}'° �'v l�l7C �T2C11� 19 °TP_li}' �J°.117C, CZdllIT�: � . _� '� � v�EYl ' '. . ,. ' � . ' _ � �P,•� . i �� 4re b�=_�inq �-,3Pr c�, tr�ct ��� � i�aye a�zn:icial �z�_ 5` �; tt�e w.�ayer t�`�"i.\' p?SC�'lav-01?%iIi = lU �1�Ui:ll:�li `1'3�:1.^.C� �25`�.2Ci. �C'_'-�]+� `?�0+.'R� 1�J�vi151ll?� : � f cSCn'y _]��+�,._�' � I � � 0 1 des¢i t-ion sixr�m on tax st-at�mJit: ���'l l,� `�� ) y -� // %- • __ FJll'�"�I17 O^'�CJII`dC�: Qvil°'S P�� �1°_°_ SL"iID12 Gr7P.�� � -Co�c.ract r�orr�.� in P�m�ver's Office - P�cnrd ib. Page I` a;iy �rtion oi the resid�-�tial st��ctvre or tt�e land, noE e�e�ling one (1) acse t}i�t �ii�::.y�dL°_I}+ SLLLi-0171715 �?d� S�'-liCi.Ur°_ '-S llSE:j t0 J7L-OC3UC°_ ll1CQ1Y°_� CI°SCLlt.`P_ i�l°_ US°_ cllT� cortia� Ui u':°_ D �C-�'�V L•i? �� Z2C� LO ai�.�3LGL L'LOPL ?�•1� o��e� cow:c_es i7! 'viPiCh ir.n.i:�dual a��rs or is bvling real pmp�sty: County '1t7:.�islu� ;l,oh�, ��-�,;'• ='h� a�rov2 staten��t is t.�-,�e, mrreVt �Yi co�i�lete. ���/ Qo iVc S�a ���� Stre2t 1i•_'-^ress (:.it�, S aid Zip *ir:ciividc•�l eit}r_r a•+�s or is ka�;�u�g uner a contract ttti�t provicls he is tn pap tlie � D1Ti�=LV tax:s on tl'_ resid�ice, or has a ben�ficial itttsest ili t}i� t�•E:a�er. - rOR ASSESSOR�S USE OP;LY - �^�,� � s�•u no� e-:cee�.��g 1(o�o) z5`�`�.��!��� S 'L••'iJli7Y�L�1Cy �°-SiG?11Cid1 1i12�D'v'E�'iY..'Il 5 �`t�nr ✓3P.fl JAi�� 1 � l•�y�� .�,Q��� �yL �iirnt,t�,8' s p�s;c±�-��i=.i ?��c�v�r�-�'-s , AUDIiOi�:, lling �l� �2� . (3) (4) G=saae (5) `lb;a1 (6) Tru� Cash Jtssess�.i Val� Valu�tion O��h� ����en�ns ��� — -��. � ,,�� , -�- r4,;ze (G) pius (�).ea��?s i�) (�) _ � ����.���_ s - _ 1 ?i+J C° �'__Y L7° ��v '_S i�`1:2r CO�TECi.� �:=1 QIRl�12t°_. � _ 1=i?.°.i.11Y°_ O:. :55°_35C? . .::, �,�:: ::. � }�i�st1�:. \7aluati^: r �i �„`�•:; ���� 1 � l.L_•: ` %//// /•// /'• . ��l f���:1:��. _ �� � �� /�� �% % ������::. � � � /// � % /// ': t° ��_: � /� ����i;> - r�CTi(li! F1' uUDiTnR - �,��: l - � � - 1.D ;