Homestead_KaysCLAIM FOR H(l�'fS1FAD PROPERT( TAX CRmIT FOR YEAR 19 ��
SEE BACK F R FILIN6.IN UCTIONS
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I,''-.,�,e) ��S �,%n�q�D (�• ���f3RA � cerrirY that on tne lst day of
n, 1�, (V7e) occ�mied as our Pr�nc��al nlace of residence the follaai.ng described real
��xty for which a Hanestead ?mpezty Tax �edit is hereby being claured:.
I , (i�e ) Q"v+mai _ _
� are buyincT under contract QV �' O�� 3,3
� have a-beneficial interest in the tasv�ayer J//�
Proc��ty Description i.n eSeN Ntu�ty I fiTO/�(A Ta.mship
Taxina District (City, Twm, hip)
p�ol p�� or legal description stnwn on tax statsient:
N��1 sW ��y �? -/—/s �RC .
Zf buying on oontract: Owness x�an� (fee sis�le owner)
Contract recorded in I�mnier's Office - Record No. Page
If any oortion of the residential structure or the land, not e�eeding one (1) acre that
ilm�ediately surro�rls that structure is used to pxomice incane, describe the use arri partion of
the omoerty utilized to produce ima�
Pny other caunties in which individual aarLS or is buying real pivvperty:
�se�-�y cPrtify the above statenent is true, c�rrect arzi co�lete.
� Rbwi�shio
*individual either owns or is buying imer a wntract that provides he is tn pay the
oroperty taxps on the residence, or has a beneficial interest in the taxpsyer. .
- FOR ASSESSOR�S USE ONLY -
Iani not exoeeding 1(one) acre i�.diately
sisroiuriing residential impmvarents
�. .� ...
Total Land
P,esidential 7lmrovelrpnts
otnes 7�roro�anPnts
Ikaelling
Garaae
(1)
(2)
(3)
(4)
(5)
q'rue Cash
Value
SO O
i
Oe
�02/0
i
Total (6) �1�,/�� �
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�' ', 7�iov�rents - Line (6) plus (7) equals (6) (8) S��aIO
Z herebY certifY the above is true, carrect, a�1 �lete.
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- ACTION BY AUDITf1R -
+werovx� :
Date:
Assessed
Valuation
�70
Hanestead
Valuation
,
i���
Dat.e
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�I��l//OO/�
•
Gibson County Auditor
701 N Main
PRINCETON IN 47670
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Donald G/ Debre K Kays
1892 N SR 65
Princeton IN 47670- - --
�IAR ffMM!) W IP_/YNI
rtaWtsj� �
IndiciJuaL� and martiN mupks arc limited �o onc homcuca� aandaN JNunion. Ax Ne racip� ol Nis'deductan becm�es
mirc beneficial, there is morc incrntun th�n aer for honxsrcacl traud Ilomc �eaJ fmuJ causes higher ta� bi,ls tor all; therefore.
HEA 1313-?(N!9 requircs uapayen who recei.e ihe haneneaJ standard deJuction in .crity Out thry are cliciMe w mcri�c �he
bentPo an1 ro pn„'ide uldi�iunai idemit)'in_ infurmatwn mtb'vrr to alluw' eounp' �tnemmenl ro bener monitor IwmeseaJ
lilin��.'lliis inlormation will M Aml Con�idrnti:d and can nnly F�� arcex¢d h� authnriveJ cmmp� o�i'¢ivls.i'ITe Ikpanmeni nf
Loeal Gurcmm<m Fiiuine ��ill u.c this fnfo�mation w creatc G�uL+ �ha� will hcln nwnre ofiaials dimiiule fromcsicad fraud.
T•rznacer Namr
Kays, Donald G/ Debre K
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_ State Parcel NumAer _
26-OS-32-300-001.033-027
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R3l3oY I�i?b�l�
Princeton 1\ A7670
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_ Leeal Descripfion _ _
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00&0703300 N SW 32 1 10 1.93 AC
P7 �
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O�.ner I - First Middlc I Last
l.�o,vc, I � Ge.c.� ��s
c Address (number nnd ivect, city, su[e, and ZIY code) - ' me m property nAd�cs; +
/$92 �(.% 5� �oS I
$ocial $ecuriry' Numbcr, last i digi�s) Ihiver's License/S�ate ID Nmnber (lasl 5 di:ils) Other (plcue specify in Part 4 belox�) I
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Spouu First Middlc // � � I Last
�e 6 ra �cu7e- �""`1 S
Mailin_ Address (�umbcr and svc<4 �iiy, stale, and "LIP code) �.Smne as pmperty mi�lrcss --� '
- /89� -/�1-- S2 �S - - - - - - - - --
$ocial Stturiiy t�umbcr (13v[ 5 dieiL�) Drivcrs Limnsc/Statc ID N�unbc: (la;t 5 digits) O[hcr (plcazc specif�� in Pan 4 bclow�) I
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Fach undersigned cenifies, under penalty of perjury, that the aboae and foregoing infonnation is we and correct and that he or sh'e is eligible ro
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recei�•e the homeslead siandard deduction on this property. Each undersiened al>o understands thal, by claimine additional homesltead deductions
unlawfully, he or she may be liable for back taxes and substantial financial penalties.
Ou��rcr I"�^ wrc Ua4^ Tcicphmc
���iyra�0a,( ,,d � 4 �9 ��om (
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