Homestead_Livermore�
I, �-,�ae)
CLAI�� FOR Fiq''ESTFAD PROPERTY TAX CRQ)IT FOR YEAR ]9 ��
SEE BACK FOR FILING INSIRUCTIONS
,, n .
�A n�2A 11v�crzA� �stifY that on the lst day of
�.,h, 19� . I, (w�l �UPlea as our prir�nal olace of resirlence the foll,owing described real
P�Y Lor which a Hunestead ?roperty Tax Credit is h�eby being c�a;,�;
i, (We) �na3 q�✓
� are buyinq ur�der ocvitract '� Q�Q — O � I I J
� have a benefici.al interest in the ta�ayer
Property Description. i. _ �. Q � � ��tl' � �� � L��_ ��P
Taxing District (City, Ta�m; iC�):
Parcel thm�er � or legal description shown on tax staEanent:
So �IU i�.�rll�-1 �5—�—�1 �.�C'-
if bwina on oontract: Owness na[re (fee sirtq�le aaner)
puntract zecorded in Fe�xder's Office - Recnrd Ab. Page
If any portion of the resides�tial strueture or the land, not e�eedi.ng one (1) acre that
irrrt�ediately surno�3s that structiuQ is used ta produce inca�, describe ti�e use and partion of
trte property utilized to pxoduce income
Pny other mimties in which irxiividual aans or is buying real property: N�tY 4bwnshiP
+� cerriry ahove staterent is ttve, oorrect ana co�l.ete.
a o
.•q�� Street Address Ci.h'. State arcl Zip O
*T.rdividual either owns or is buying imer a mntract that provides he is to pay the
pzoperty.taxes an the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR�S USE ONLY -
Land rbt exoeeding 1- (one) acre iine�ecliately
surro �ing ' -�rovanents
Other ,
Total Land •
PESidenti�,P��o�n�s ' p�l� ; M,
�� o. Garage
AUDIT�R ��
ot2,er Zc�rovanents
��e Cash
Value
(1) �00
(2)
(3)
(9)
(5)
(6) l37 90
c�) _
� ' Irtg�rovQrents - Line (6) Plus (7) e�uals (8) (8)
I hereby certif]' the abbve is tr�e� correct, ard oa�lete.
�anature of Assessor
- ACTiON BY AUDITnR -
Assessed �
Valuation
/�O �
////����/��
��//�����/ ,
• Oate
�
lv�oroved:
f� O �" ni ' �� Date: � � � � ��
�
iicmest_ead
Valuation
/ 7 c7
-•-
�������/�/����%
�/OD�������
�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
2011
�TiTEhf10.\I!)MIR`lfwl
iRF.15UAE0.iO0.M:S1A
RfMMCElC61.�4]-RI
IWiriJual aud m�rrieJ mupin arc IimiltJ to orc homrseaJ .ta�MaN �ituction. As thc �cceip� ol �hii deJuction bttronre�
merc beneficial, therc is morc incrnmc Ihan aer (or homestesl fnucl. Ilomn�eaJ irduJ auses hi�M ta� tiills for all: thertfae.
HEA I3�is-?IX19 requ'ucs u�pa.rn v:ho rercive iM1e hanmead <�ndird JNuction w.cri(y that �he} ore �li_iNe to mcenc the
benefii an1 ro p�m'idr a�klitiunal identit�'ine mturma�wn necez'vrr ro allw' coung� gv:cmmrn� �o Nne monrtor homeseaJ
filin�. This inlomu�ion xill M Aryv mnfidrniiil and ren nnly h arcc_ uJ M1y wihnninl rnunry nlTriaL� The Ikpanmrni o(
Local Gwrmm<m Fi�unc< ��ill u.c this iniomu[ion m crca:c 0.vls Oui a'ill h:lp as�nn' official. dimnurc homcstcaJ fraud.
Tazoa��er Name
Livermore, Billy Mac / Penny
�
R I 6ox197 \�
F'rincc�an INI;7670
Billy Mac / Penny Livermore
3363 S 100 W � State Parcel Number Lesal Descrintion
PrincetonlN 47670-9343 �
�i�n��ni�i��n�in���u��i�iu���u��i�����ii��in���i�n��� 2Cr11-25300-001.195027 006-01195-OOPTSESW 25271 1AC
— — _ _ _ _ 017 ___
��-- - - - - — -- -
rott I Firsl
B_L�y
; Add`¢t (numbet and ivect, city, sm[e, and ZIP code)
'J?v(D3 S I00 �% �f i
�
"e �^ �' y I
!! Address (Number and s�tteL ciiy, state, and ZIP cak)
33(�3 5 � oo U�
L� Ve�('fr�0
/ � $:vne:u ptapeny address
1 " �-f Z t� '1 O
Othcr Icasc spcciN in Pan±bclow�) __
mdersitmed certifies, under penalry of perjury•, that the above and foregoing information is we and correct and that he or s
e the homestead standard deduction on this propeny. 6ach undersigned al>o understands thaL by claiming additional home
fully, he or she may be liable for back taxes and substantial financial penalties.
� s;�� ���yl� /io T���,h�,� �
�
rf.. . �a r
� ��.v t/tirKc-�`
elieible w
deductions