Homestead_PughCLAthi FAFt HOAAESTEAD PROPERTY TAX
CREDRlSTANDARD DEDUCTION
shtle Fonn s�tT3 (R7 � s0�
Pieacrbed by tlie �epeMaq oF Lo�l Gaue�maY Fmmim
INSTRUCTIONS: See ieverse side (a filirq instrucL'ons.
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Fo� —1
HC10
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I M�e) � cer�fi�ty�,�tlnial on the 1 st day of March, 20_
I(We) ocwpied as aa prmdpal plaoe M resid e fo8owirg d property for whirh a Homeste�F7bp�7" "�'i�.J�eit is hereby daimed:
!� �(We) owned ❑ Are buyug under cantraC �j 1
Have a benefid� c�ffirest in fhe entiry tl�at is liable Ax C�e property �ces m fhe poperty and Mat owns tl�E �r�iSL�ying under a mntracl
� ' i � ..CONTRIICT<RECORDmk`u.'.i eF. 34f:✓r„?�. "'�.:'t::i:. � -_`±�`'.7.4..:i+.-.
. ... . . . . _ . . .. _ . :... . . �-
� re dryug on m�trat. Fee sirr�le a.nera reme
f�arde/s otbce whca cartiaa is recadeE Record numbm Pege
�b
Towr¢lup
d�uiption
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b U�e
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��—� �—Va � U�(�%y •..�.SCY�%.) G�- � ' � ��P��Y l..l MahibFlome(LG61.1-7) -
n a�y v�� orcna �d�ai� s�,m,�e a me �d „w �� ��i � eva a�:nm�y amae,as uw awm.a o usae m prom�oe:�mn�e. ees�,te me �ne m,e Porna,
w Ihe p,opary imBma m p�od�se mm�,e.
� I d5 o n I�ase.d �ro c�r�d
Counry
r
Tornship
I hereby ceAify fhe above sfatemenls are true. oorted and caryle0e.
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��.. rASSESSOR USE ONLY '� t.� yi� ;.' iRUE TAX" ASSESSm Vf1LUE ` F�STEAD `� C¢ � ANONitESIDHJ7U1LYjq j �
' � , � � �k..., t VALUE::� AT t00X OF TTV s + VALUE .7 � � v � s � YALUE � Y "^�' } �
.,i.. C •�. , �n >. ., . ; ... ,.. e. .u.. .d'...,... �. r..,-� rxY Ils au�+t,�
Lm�d rrot e�cee�ng 1(one) aae immadiately � � rttii+'e�; ��`��} -�1-� �`+'�,Y�' t}�:
siarowd'vg residen6al imp�o�b. � � y o Z*„�kv!'n .��;C. °�Fl.r..'S:2.�'-Ta'�"»��i
ONer land �p) � r .
Ttt� lard (Icie 1 pkrslme � (3)
� ��+�?� ���.':. an;Y�i�!,s'
Resdential unprvvcYnents arMrnialy ��� (4) ",. a.'.55K��,�Y��v .� ����: �:s�i„��;;o4y'f��
r�tt.� x� nu r 4} ��-Y
0.sse�ed Alohde / ARarpAe�aed FlOrtie ��e (5� . c� .�'�+4;..:a7.°h� :�d3a��I ��'*+ �t��
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ONer intprovert�ents (6)
Tdal urryrovert�ents (I?re 4 Buwn�A fine 6) �7)
Tdal value (I'v�e 3 pda 6ne n �g)
I I�eby cErtify the abwe is true� cartea, aM Sier�ama otAasesw Data cipied
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Y4iyug aWm - Si�aLae olAUdtu Da�e sgied
. • .STAlIDARD
2(1 _ Pay 2b _ I
Lesser of 12 Homest�d
Valuation w S35.000 E
C �
Gibson County Auditor
101 N Main
PRINCETON IN 47670
rv tuwcwzr��n
C�ILV NQ.T lPA\CE If LI.1 �_J.1
O�diriJuals anJ ma:rinf muples are limimd to onc home�tead �andaN Aeduninn. As �hc «xeipi nl this deduction Umomcs
more beneficial, there is morc incenmr Ihan <�er for home+teazl fraud. NomesttaJ (nwl causa higher tm�bilk for all: thercfore.
HEA 13+3-?IX19 requims uxpa�en who reccire the hanes�eaJ standard �vluction io mril'y thai �hey are�elieiMe io mcei.e ihe
benefi� aixl to p�a'idr a�Witional idenuiying infumiation �assan ro allou� counrr gmrmmrnl ro beuer moniror homesxaJ
filinb�. This infarmalion wili 6e Aryw cmlidential and r�n only f+e areessed by awhorized counp� niTciaL�.'fhe Ikpannrem of
Lucal Gwannnem Fiwm'< will ua �his inio�ma�ion to cr<att eools ihat o'ill h;In cow�K o(ficials eliminate homesrcaJ iraud.
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370
star,iey w P�9n ,ir. MAY 2 0 2011
do Steven Pugh �...�
5474 W SR 64 C���� " V
PRINCETON IN 47670
GIBSON COUNTY AUDITOR
Tasoaver Name
Pugh, Slanley W Jr
l`
on 1 Pugh?6-I I
State Parcel Number Leeel Des
2611-0&100-704.358-027/eldg on Lsd Grd (
This form MUST be retumed to County Auditor's office.
Please do NOT send this form back with your tax payment to the county
S��/�1�1i
'W f� �l /tl�
g Address (numbcr and sme[. ciry, sutc, and ZIP codc)
-y �/ t��st sf �e RD � `l
$
Addras (Number and stree4 cily, stale, and "LII' coJe)
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iame as propem addrzs�
Othcr (plcuc spccif in Pan 4 bclow)
� Same u property edd+es5
Securiry Numbtt (lazt 5 digits) � Drivefs LiccnsclStaec ID �wnbe; (la;� 5 di¢its) � O�hcr (plaue specif�� in Part 4 belou�)
598-0?7
rer.
idersiened certifizs, undzr penalN of pequry, that the above and foregoing infortnation is we and correct and that he or stie is eli4ible to
the homeslead standard deduclion on this property. fach undersigned al>o understands that, by claiming additional home�itead deductions
illy, he or she may be liable for back tases and substantial financial penal�ies.
Sismaturc
S� _ZOf � Uau I'
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