Homestead_Livermore .(3)Gibson County ,4i�d�tor
101 N Main
PRINCETON IN 47670
� T
Y 1 � � L
— �° NOV 3 2011
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��$�ON COUNTY AUDITOR
11alE FAAM!!K IIC / WI� fRFASUI[P F)0.N :FI.�
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' 1 ' • � � � 1 . . � . . � .
InJividuaL. anJ ma;riN coupks are limiinl to om Immc.ucaJ etandtN Jnluc�iun. As �he �eceip� oi ihis Jedunan bttome�
mure beneficial, therc is morr incen[ire thm e�er (or homdieael &:md. IlomesttaJ &auJ wuss higher tac bills for aIC therefore.
HEA GI-i-?(N19 requiies laapa�en ��ho reecire the hqneslcaJ standard Jnluction w.erilv tha� th<y are ci ciMe io mcen. �he
benefi aN m prw�idr akliiional idrnuirmg iniumu�wn mm'vn� m allw� caunn gwrmment ro barcr munitur Iwmrneael
filin�. Thii inlarmalion x�ill hr Ae�x cemlidcNial aiul r.m nnly h� xcei�cJ br aWhnriini roumy o(ficials. �ILe IXpanmem o(
Lceal Gmemmem Fi�unee eill mc thia infonnaion m creaec ux�ls that �vili hdn c:x�nrv nBicial< dimiwie Mmenead fnuA.
/ Esther P Livermore
525 Meadowlark Dr PO Box 412
PrincetonlN 47670-0412
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undersitmed cenifies, under penalty o( �qury•, that the above and foregoing infoRnution is we and colrzct and that he or she is elieible to
:e the homesiead standard deduction on this propeny. Each undersignzd al;o unders�ands that, by claiming additionai homesti ad deductions
,�fully, he or she may be liable for back taxes and substanrial financial penalties.
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WPA1 HC 10 1979
PrescriCeG By Slate BoarO ot Tax Commissioners
io Be Filetl in Duplka;e
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 � y
SEE BACK FOR FILING INSTRUCTIONS
�(We) ��-��-- '
place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) L� owned Dol_ � O J19y
❑ are buying under contract ���
❑ have a beneficial inQt,ejrest� in the taxpayer (�
Property Description in �•^ County v�� Township
Taxing District (City.�ewn, Township): �����
Parcel Number 'or legal description shown on tax statement:
�.,vJ-r+-,�. 7� a.,��.ti v� o-� Z`% �
If buying on contract Owners name ��� simo�e owneq
Contract recorded in Recorders Office - Record No
It 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.
' /..17 �.. �-� 7` : '. . . . . _ . , � 1l' a_. /�. O �.—� �l. � .
County Township
ana
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 Land � � � � �
Residential Improvements Dwelling
�, � � g �a?g
� � Garage
Total
Other Improvements � � �����i��
T ' Improvements - Line 6) plus (7) ag�pt��$)
I�eby certify the above is true. correct. and complete.
Si9nawre ol / sessoe
True Cash
Value
(1) �aleo
12) `
(3 ) 2 Z lv o
(4) /L 8 Po
(5) �
(6) lG 880
(�) —
�g� /G 8 8a
- ACTION BY AUDITOR -
Assessed
Valuation
7 So
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Homesiead
Valuation
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Date: 7-9- 7