Homestead_Larson�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
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Judith M Larson Sr.
1839 N SR 65
Princeton IN 47670
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IndividuaL� and nurriN mupb are limitcd m ore homcacsJ aandaN Jcdu.iion. A> ihc raceipt o1 ihi> ;JeducYwn becomec
mure beneficial, thrrc i. morr incentne than aer for homesteal (nwl flome��ead fiaud ca� hi�hcr tac bills for all: �hercfae.
HEA 13�7i-'_IN!9 rcquim taxparen who rvceire ihc haneveaJ <inndarJ �kviuciion m.erily ilv� �hcy am cligi6le �o meei�c thc
benefit an1 ro prm'idc additio�ul idenuirin_ mturnu�wn nece.vey �o �Ilw� counn� em'rmmeni ro Ntrcr'mmiror lamestexi
filin,�>.'I7iis inlnrmminn x�ill M Acry erntideniinl anA can nnly M� arm.eA 6y awtmrird munq� of&ial.. IThe Ikpanmm�t nf
i.ucal Govcmm<m Pi�unce ��ill mc this infortna[ion W crea:c 4ols �hat will h:ln coumv otTixial. dfminalc Mrme>t<aA IrauJ.
Tainarer Name
Larson, / Judith M
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� $ame u pmperty addrea;
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E.ach undersigned certifies, under penalry of perjury, that the aboce and foregoing infoRnation is wz and coirect and that he or she is elieible to
receive the homes�ead standard deduction on this property. Each undersicned al;o understands that, by claimine additional home �tead deductions
unlawfully, he or she may be linble for back ta�ces und substantial financial penalties. I
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Preuribe0 By SWte Board of 7ax Commissioners
To & FileU in Mplicate
1
CLAIM FOR HOMESTEAU PROPERTY TAX CRE�IT FOR YEAR 19 �`�
SEE BACK FOR FILING INSTRUCTIONS
�(We) �, ���• +� %'�u-�-�-�certify that on the 1st day of
March, 19� I, (We) occupied of r idence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We)� owned oo� "f�'IL�
❑ are buying under contract � V
❑ have a beneficial interest in the taxpayer
Property Description in �—�-�-a-�`' County ��a-- Township
Taxing District (Eitq�ewfr; Township): ��-�'.--��
Parcel Number or legal description shown on tax statement:
��. A/ i SE��� �i—i—io (i'��'�9�F�
If buying Ofl contract: Owners name ��� s�moie owner�
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:
�hereby certify the above statement is true, correct and complete.
n
�
'Signature
County Township
iQ # 3 l/�Pi�,G��-�! �
AECress
Ciry, State end Zip ('qp¢
' 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 improvements
Other Land
Total Lantl � {��g � �
Residential Improveinents� � Dwelling
.; 1^-.f�
_ � ! �-
True Cash Assessed Homestead
Value Valuation Valuation
(i). /coc
(2)
(3)
(4)
Garage �5>
/���`�� Total
Other Improvements�
T�Improvements - Lin -(6) plus (7��equ�iS (8)
I hereby certify the abo� is true. correct. and complete.
Si9naNre oi Asse530r
(6)
(�)
(8)
c 330
- ACTION BY AUDITOR -
� 7 7
Date
Approved: ,���__��.�.� Date: ���Z'�,y