Homestead_Michaswan+ Mc io ie�s
ReuriUeO By State Boara ol Tae Cammissioners
To Be FiIM in Duplicate
CLAIM FOA HOMESTEAD PAOPEATY TAX CREUIT FOR YEAH 19 � 9
SEE BACK FOR FILING INSTRUCTIONS
�(We) ��/ � G��'"�"" ��" � E � ""n-�� certify that on the 1st day of
�vtarch, 192`L, I, (We) occupied as our principal place ot resi nce the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) � owned OD� - ��3�5
❑ are buying under contract .
❑ have a beneficial interest in the taxpayer
Property Description in ��'^ _ County�---� �°��-� Township
Taxing District (Giiy-�owrTTownship): ���^-
Parcel Number or legal description.shown on tax statement:
� i% GCJ ��/ /S- � - / c ( � A )
If buying Ofl contract: Owners name (�� SimD�e ownerl ,_ r��y.Q
Contract recorded in Recorders Office - Record
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.
� ,�_._� � �a .�.. y�-t �.
County Township
ana Zip CoEe
' 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
JU�4 2 : i979 Dwelling
� �/�i4��Garage
� Total
Other Improvements // AUDITOR
Tr� � Improvements - Line (6) plus (7) equals (8)
I�,by certify the above is true, correct. and complete.
Signaw�e ol nssessor
True Cash
Value
(7) SO o
(2) 90
�s> �90
(a) / 8'foo
(sJ _
(6) / 8'�00
(�) —
�8� / S sLCo
ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
/ 70 /70
� !jjjjj�jj�j
_ ����%%%��
; -- •
•-
, .
.,.
Date:
+
. - .. �l{iEFMt\I!1W11C'Jf•NI 'iFlAS�IAfRfO0.V�l1A
n�YRO.'EDtlT[��TEBR�N��KMr.��:�ia.`nn PAfARIBT0Yi11f.DfPA0.1� fUFIDIaLGT21lYMfAifR:�\CEIt'bl.l-l'JI
Gibson County Auditor � � � � �
101 N Main � � � � � � � � � �
PRINCETON IN 47670 InJieiduals and ma:�inf coupl� are limi¢d to orc homeaeaJ �randaN d,�luninn. As ihe rttript ol'thii dcduninn becomn
more beneficial, thrre is morc incrnmx dun e«r (or humesteacl frauJ. Ilama�ead GauJ caus� higher la� bills (or nll: therefae.
•\ HEA U33-?INW «qu'ves uapa�crs �ho nteire Ihe hanestced <�a�darJ JNuttion to vrrily ihat ihey arc eli_iNe io rzcei.e ihe
bencfii aN m pmridr :xldiliUml identiO'im; in(Wma�wn iKttsiln' tu �IIW' aWnh' ememmrnt [u beile� rtulmror homesreaJ
filin��.11iis inlorma�inn w�ill M A�u con�idenli�l anA nn only h: accrz¢d hy autMrized rmnitr o0ici:�IzJThe Ucpanmem nf
Iwu�al Gm�cmment Piiu�rce oill u.c thie inturmatiun m rreme twis that will h:ln counm ofkiak dim� im humcsmad RauJ.
K_[:_I
N" olas Wm /Peggy Ann Mic
651 E Top Hat Rd
�Pnnceton IN 47670-8850
I�i��ll���l�ll��l���lll���l��l�l��i��
TJSpJ1'ef I�iJ1I1P
Michas, Nicholas Wm / Peggy Ann
/ State Parcel Number Leeal Descripiian
26-12-15-100-001.315-027 OOS-o1315-ooPTNW�152709.11AC
��I�I����III�I��I �-�
�
o„�« i e�rs�
_ f/C�/� G/-J�S' t(/lL-� I F/ /
g Addresc (numbcr and succc, ciry, scam, and ZIP codc) -
� � - v O, i. �'
$ocial Sceurif}' Numbcr (last 5 dieils) Driver's License/State ID � mbcr (lasi 5
.�—
Other (pic�se specify inTart 4
Pe �.�, �/ I/�I NN M I c. h�..s �
Mailinc Ad�dres5 'umber and svee4 ciq'. slale,:u�d "LIP ealr) �y{ Smne � p'operty ad�ec. (
� � � 1 � , � � � P�.,�.- ��l/ -�}-�� 70 �
Social Stturirv Num6cr (last 5 dicits) Drivcrs LiccnsMSUm ID Niunbcr Qaa 5 dieits) Othcr (plcasc spcci(y in Part 4 bclow�) I
. � �
. . ,
Each undersi�med certifies, under penalty of perjuq�. [hat the above and furegoing infurmatiun is we and correct and that he or slie is elieible to
receive the homestead siandard deduction on ihis property. Each undersigned al;o understands lhat, by claimine additional homestead deductions
unlaw�fully, he or she may be liable for back taxes and substantial financial penalties. i
R.net 1 Si!mauuc Uatc 7'clephmc /