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Homestead_Madisoni � d�n' ; CLAIM FOR HOMESTEAD PROPERTY TAX i� " CREDIT/STANDARD DEDUCTION ��• State Form Sa73 (R2 / 5-92) � �;:'; �fi� INSTRUCTIONS: See �everse side for �iling insfructions. n � - ncere�n.ri FORM _YEAR HC70 �_ ��_f _���(YJ[�,(�Y�� certify ihat on the lst day of March. 79_ �,upied as our i cipal place of reside e the following described real property for which a Homestead Property Tax Credii is hereby claimed: � owned ❑ Are buying under coniract- a beneficial interest in the entiry ihat is liable for the property taxes on ihe propeAy and thai owns ihe property or is buying under a contract. It buying on conimcL Fee Simple owner's name ,. Recortler's oflice where contract is recorded County Township PROPERTY 'APR = 1 1996 Re num6er Page �n,�. ,Fi'. I s v �%r u ber Legal de5cription 'b �_591- c�0 ' If any portion oi the residential strucmre or the land not enceeding one (1) aae that immetliatey surrounds that struaure is usetl m produce income, describe ihe use and portion ot ihe pmperry utilized to produce income. . Counry PROPERTV OWNED BY CLAIMANT IN OTHER COUNTIES =ertify ihe above siatements are irue, correci and complete. \, 1 (number and streel. ciry, stare, ZIP wde) � .-� ASSESSOR USE ONLY Land not exceeding t �one) acre immediately surrounding residential improvements. Otherland Total land (line 7 plus line Z� Dwelling Residential improvemenis Garage Other improvements Total improvements Qine 4 lhrough line � Total value (line 3 p�s line � I hereby certify Ihe above is true, correct. and complete. Verifvinn artion - SionaWre of Auditor 19_Pay19_ Lesser oi tl2 Homestead Valuation or 52.000 � TRUE TAX VALUE (�) (z) (3) I4) (5) (6) I�) (8) Signature of Assessor STANDARD of claimant ASSESSED VALUE 5 . . i � : —'. HOMESTEAD VALUE NON-RESIDENTIAL VALUE Date signetl Date signed i Gibson County Auditor 101 N. Main Street ' Princeton, IN 47670 , ��� =FIL,ED� --�� �� NOV 28°2011 — G�.n� — GIBSON COUNTY AUDITOR 482 _ Stanley A I Mary A Madison 625 S Old SR 65 Princeton IN 47670 SGiEfORA1515f9(PJ/&10) ' TPF.�SL'FF3f00.NR1A APPRq'FDBI$IVEHMRUOl�[CUUYtCgA .� Y0.FYA0m�YTEOtPMM.E�TOF�Lf'ALGO�'IA�MEYT4IN�V(£IC61.1-E33.1 � , � , • � • ' � � , � � � Individuals and martied muples are limimd ro one homutead standard deductioa As the receipt o( this deduction 6eromes mort brneficial, thae is more incrnlive Ihan cvcr for homrnead Gaud. Homatead (2ud causcs hi�tt tax hills (or all; �erefore, HEA 13M-2009 mquires ta�pa}crs wta recci�c thc homestcad standazd deduttian to cttify �hac thcy �vc cligiblc to r«eice the brnefil and to prmide additional identiFying infortnntion ncccssary �o Wlow county gwenuncnl to Irencr monitor homestwd filings. This infomution uill be kepl wnfidcntial and can only be acecssed W au[horized cowry oKtcials. The Departlnent af I,acal Go�xrnment Firmnce x�ill use this infortnation ro crtate tools that will help counry' officials ellmirute homesiead fraud. Taxpaver Name Madison, Stanley A / P Il�l�lll�ulll �III�I III �II LocationAddress � / 470 W � � �pRiNCETON IN 47670 � l - , State Parcel Number Legal Description 26-11-16-100-003.591-027 PTNW1621130.3a4,4C D-17 � � ----� i � . v � i �'. / J ' 1 This form MUST be returned to County Auditor's office. ; Please do NOT send this form back with your tax payment to the countj% treasurer. stA� � � � a5 S o�� �cial Security Numbcr (lact 5 digits) � � � �1 �^��sm� � �� � :IPcode} . _ � _ ' �� e /�t �o �i� � ; h /'� f o LiccnsdState ID Numbcr (lan 5 digits) � � � T �� MQ d�SO/'! 1 J � 2� � speci(y in Pan 4 hlow) �� , i' �� !� �bove and foregoing infortnation is we and correct and that he cv she is eligible to ��• � }ate Telephone �, �.V, w , , , �..,.�..o - - - - E i �-a �-ii ;