Homestead_OldhamFOflA1 XL 10 7979
Prescri0e0 By State BoarE of Taz Cammissioners
To & FiIM in Du0licate
CLAIM FOR HOMESTEAD PAOPEATY TAX CREUIT FOR YEAR 19 � 9
SEE BACK FOR FILING INSTRUCTIONS
�'(We) �--�--���! ���-� ���ewL �cL£�-.�-�.•.� certify that on the 1st day of
March, 19� I, (We) occupied as our princip � place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) f�owned ���b�l/7O
❑ are buying under contract � �
❑ have a beneficial interest in the taxpayer
Property Description in � County ��`�"`� Township
Taxing District (C�n, Township): ��
,
Parcel Number or legal description shown on tax statement:
oSL.v'/,L ao - z - /c �i/J �
If buying on contract: Owners
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: County Township
�heceby certify the above statement is true, correct and complete.
///�
/Ii�i�,(!�' � il�,� /�FD i ��� ,--% . ��
. �S(gnature Street noareu ' Ciry. State ana � ip Coa�
' Individua� 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
True Cash Assessed Homestead
Value Valuation Valuation
(�) � co / 70
(2) —
� � � �-,a � S�: a
�
Dwelling / 9a 3c
I�i!�6arage�q�� �5> —
� '°• V Jr
Totlal/ (6) / 9� 30
Other Improvements ���,C� J��) —
� c�.�.n
I'��Improvements - Line (6) plus (7) eq s(8) S') / 9z 3c
eby certify the above is true. correct. and complet�UD�TOR
Si5^a�u�e ol Asxsso�
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/70
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Approved: ��r�-���o-��-y� Date: �o- �o-Z,9
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
4�48
mruuuxroRVS�n
IndiriJuals anJ marrieJ aoupb arc IimiiN �o oce homc.teaJ aanAanl J�du.�ion. As the �eceipt o1 thii dNunan beconrce
murc beneficiai, there is more incrnti�x thm ecrr (or homesrcaJ frauJ. Iiumesteacl BauJ cau.� hi�her ta� Gills tur all: therefae.
HEA I+J1-?(N)9 mquirt� u�papen who rcccire the hanestmJ sianda�d JcAuctian to .erily �Iwt they am eligiMC Io mcei.e �hc
brnefii am1 ro pnr�iJ<:MYlitio�ul idenun'im: infomv�nun riecessan� ro allw' counn� gm'rmmrnt �o Y.rtrr mmiror homrste:wf
�ilin�,-. Ihis inlnrmaiinn will M Ary4 mnlidaLial and nn nnl)' M• acre: �nl hy nulhorvN cnunly niToinl:. �1'M1< Ikpannum nf
I.uc�l Gwertmem Finam'c ��ill u.e this informanon to crea[c [rol� �ha� will h:ln rounn uffirials dimir�m h�mc�t�ad &nud.
David Oldham
860 E 250 S
-� PRINCETON IN 47670.9255� '-- - � ' - -
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(�A-� ��d
�•e Address (numbcr wd �mxt city, smtc, end Z
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$ocial $ceurily Numbcr (last 5 digits) Urivers I
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� perty eddres;
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Other (plesse specify in Pan 4 below)
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E.4ddres5 (\umber and sYrcei, cily, � W le, nnd LIP cotk) �$ame u pmpeny eddrtms
�O� ��OS 2i�✓L�.�J %� �%�7�
Sccurity Numbcr (last 5 digits) Dmcrs Licrnsd5tatc ID Niunbcr (las� 5 digiti) Ochcr (plpsc spcciF in Pan 4 bclow•)
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20 2 10 1 AC
sicned cenifizs, under penelty of pzrjury•, that the above and foregoing infortnation is we and wrtect and that he or sfie is elieible to
homestead standard deduclion on this property. Each undersiened al;o underslands that, by claiming addi�ional home<.'tead deductions
. he or �hj maxbt�b�(osbayk taxcs :uid substantial financial penalties. j
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