Homestead_PaulYieXUO.tl i3; Stal¢ 6oai0 ot la� Lon�ussone�s
CLAIM FOR HOMESTEAO PROPERTY TAX CREDIT FOR YEAR 19�
FOR FILING INSTRUCTI
�s�-e>i��-e�
I, �) — • V��C certi(y that on the 1st day oi
M. .i, 19 I, We) ccupied as our principal place of residence the (ollowing described real property (or
which a Homestead Property Tax Credit is hereby being claimed:
I, (We)`i� owned
❑ are buying under contract
❑ have a beneficial interest jn �he taxpayer ��
na .II...�
Property Description in �1J'�1lO� Counry ,—� , Township
Taxing District (City, Town, Township):
Parcel Number.
If buying on contract: Owners
owneq
or legal description shown on tax statement
�-�. �l�)�'�f �W�'4 a0-�-/0 . `�5�
Contract recorded in Recorders Office - Record No
If any portion of the residential structure or the land, not exceeding one (t) acre that immediately surrounds that
structure is used to produce income, describe the use and portion o( the property utilized to produce income
Any other counties in which individual owns or is buying real property:
certify the above statement is true, correct and compiete.
Y
S�reei nooress
County Township
ana Z�u Goae
' Individual either owns or is buying under a contract that provides he is to pay th��erJy_ta]oQ� u p
on the residence, or has a beneficial interest in the taxpayer. `�'"��'�1'"d
�
- FOR ASSESSOR'S USE ONLY -
_and not exceeding 1(one) acre immediately
surrounding residential improvements
�ther Land
iotal Land
Residential Improvements
Dwelling
Garage
Total
lther Improvements
fotal -ovements - Line (6) plus (7) equals (8)
here�.Y certify the above is true, correct. and complete.
1�)
121
(3)
IQ)
(5)
(6)
(%)
($)
True Cash
Value
i�giutu�e ot Atsesw�
- ACTION BY AUDITOR -
IApproved: � � ' �� ' +�c^"" --- — — _
���Q � � 1�1�y
/�ssesS�!DITQR��ead
Valuatio�i� aluation
�
Dat��- 1 � �-u /
� Git°�i County Auditor
101 iv Main
PRINCETON IN 47670
�
5%0
51\tE fORN!)•e+IR!!+n�
iY:M1�fElCli.l-_!.1
Indi��iduaL. anJ ma;riN mupk� are limited to nre Iromevcad �andaN A.1:Au.�ioa As ihr rcttip� of �hi� dedunan beconrcm
mure beneficial, thrre i� morc incrn[nx than ner (or homeircad frauJ. Ilomnrcad faud causcs hi�her ta� bilL (or all: therefore.
HE.\ 13iJ-2009 requires uxpayers whD rreirc Ihe hana�caJ sundard �iluetion m verify rfwt tAcy are eliciMe to recei�e �hc
benefi� anl Io pnn'ide a4litimul idrntiirin_ in(wma�ian Mcrs'vn to allw' counn� �rmmmi ro bcucr nonimr MmesrcaJ
tilinf�- Iliis inlarma�ion w�ili br {.ryv mnli�iemial and ran only h: accesseJ M1r amhoriinl ronnty ofhciai... 7'he IXpannxnt nf
lual Gwcmmrnt FitiMC �vill u.c �his iniormation ro arca[r uvb �lut x'ill h:lp avunty oBcials <liminate homcshaA fmud.
� � � � � � —
Taxpa��er Name Prnpertr Address
Paul, Jeffrey A
k� z�o.r es 55`t C 1 5�' S.
Princcton 1\ 47670
Jeffrey A Paul
559 E 150 S
Princeton IN 47670-8711
I�I��II���I�II��I���III,��I��I�I���l�'��II���II�I�I�I�I���I�I�I
. _ .��wncr I First �/
Tr'FFQEy rl
c Addmss (number m�d svee[, city, smic, and ZIP code) � �
.ss9 �. iso s. P,e�NC�-�oN �n�
Social
K
ine Address (Number anJ atree4 city, 9a�c, and ZIP code)
s�s 9 r.� s o s., P,e �,vct Toni, in�
� Sccurih• Numbe� �lazt S diei�s) Drivds Lice2�c/SUtc ID Nmnbcr (lazt 5 d
( �
State Parcel Number Leaal Descriotion
2612-20-100-001.743-027 oes-o1743-0o PT NW N�N 20 210 .4�6
_l AC D10
/ `
1�A U L
" " — � Sumc � prupcm ul.itiv
y � ��o
Other (please sptcify in Pan 4 yelow)
y���o
(Plcatc
P�t u c.
ss propem address
Fach undersiened certifies, under penalry of pepury, that the above and foregoing infurmation is we and w�rzct and that he or she is eligible to
receive the homesiead standard deduction on this property. Hach undersiened al>o understands that, by claiming additional homestead deductions
unlawfully he or she may be liable for back taxes and substantial financial penalties.
0..ner 1 Si c' _ p Uev^