HomeMy WebLinkAboutHomestead_RoyGihson CountyAuditor
107 N. Main Sireei
Princeton, IN 47670
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— OCT 19 2012
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G�N COUNTY AUDITOR
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Indiciduala anJ marritJ muplr. are limi�nl �o onc honx�i �ad �iarxtud Jnluoion. A. ihe rttrfpi nf ;hi; dNuciim� become�
mon AcncficinL Ihrn is rtwrc vcrnti�e Ilun cvcr for homestc�d GauJ. klumcACad (nuJ ca�a� iiehcr u� b�jlls (or �Ih �h-rr(ore,
HF:A 13i3�7009 requim Iacpa.rn uio �ee�ire :hr homotcaJ �tanJarJ dnluction to cerify th.at dny arc elioiblt [o nrei�e �he
U�ncfii anJ m prm�idc aidiiioaal idrnlifi'inc Sr,fnrmaiion rKCCt�n' lo �Ikre counrc gm'cmmcm �o bii�al �niior hort:cacad
filieu.'fhi> in6mu�im will br keq cmfiJnnial znJ can onk h atcs.ieJ M' autlwrizeJ counry� otTicial�t Th< [kparimcr.t o(
Lucal Gnecrrncm Financc uill usc ihi. infartnaiion m cna�c tmlc :hat x�ill hcln counM1� ofhcul> climintn� homcucaJ Inud.
Jason W Roy
3078 S 175 E
PRINCETON IN 47670-9252
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Taxpaver Name
Roy, Jason W
3078 S 175 E
PRINCETON I� 47670
II�I �I I I O ulll �I I I II I
State Parcel Number Leaal De'scri
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26-12-28-300-001.708-027 PT E SW 28 2 70 .66 AC
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county
�� � �;F� M�a��r
, ��SoIJ �"°�/ �Uc
�iling Addrtss (���r and strcet, city. sta:e. and ZIP code) � O,, g S j?� t�
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P R x,� e.e +o,�.J Z.lJ �-d 7 6 70
<ial Saunn• Numbcr Qas[ i digiis) Ihivcr's LiccnsclSmtc ID \umhr (Iba: 5 Ji�i's)
ouse Firs� Middlc
Address (�wnEer znd s'.rtce, city, s�ate, and "LIP code)
Sccurity Numbcr Qau 5 digiLS) � Urivc{s Liccnu5tatc ID
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Qs�� � �o�n. �aazss
Other (please specifr ir. Pan 4
� Same as propem add: ess
Snx
Oiha (plcasc sp:cifi' ic Pan 4
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D-10
undenigned cenifies, under penalty oPperjury, that the abo��e and foregoine infortnation is we and correct and that he or she is eligible to
ie the homestead standard deduction on this property. Each undersienetl also underslands lhat, by claimine additional homestead deductions
: fully, he or she may be liable for back tases and substantial financial penalties. �
� I Si=nzturt Dxu Teleplroae �
Sa-oa� �/ l0-19-�� (
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FOflM HL 10 1979
P�esc�iGetl By State Bw�E at 7a. Commissianers
CLAIM FOR HO
PROPERTY TAX CREDIT FOR YEAR 19 ��
SEE BACK FOR FILING INSTRUCTIONS
io & Filet in Duolicate
�(We) 7 � - certify that on the tst day of
.iarch, 19�Y_, I, (We) occ i d s our principal place of residence the tollowing described reai property for
which a, Homestead Property Tax Credit is hereby being claimed:
I, (We�wned %ti0�p —b�7Qg
❑ are buying under contract v
❑ have a beneficial intepr�est �in the taxpayer � � /
Property Description in ,�c-�-o--�r- County �`�-�'--t Township
Taxing District (CiL�rrlewr,rTownship):��-�--�--
Parcel Number
If buying on contract: Owners name �'� ��"'o1e
or legal description shown on tax statement:
G�� �'�z Sc.�''� as-� - �o ��� )
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 com lete.
'4. l
' ia �e $treet NOdr¢55
County Township
�. 'Y��7�"J
ann ZID CoCe
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 ONIY -
. - True Cash
' Value
Land not exceeding 1(one) acre immediately �oo
surrounding residential improvements (�) �
Other Land � M� (� � � (2)
Total Land n L� (3) 3a'O
Residential Improvementsi��� z ia7� Dwellin
_ 9
/� //���i£-Q^""/ Garage
/-1/� Total
(/l �
Other Improvements p�pITOR
Tr�-� Improvemenis - Line (6) plus (7) equals (8)
I�by certify the above is true. correct. and complete.
Sigria:ure oi nsseswr
(4) �2 /�o
IS) 5�0
(g� ai90
(7) 3 70
�g� a S6 0
- ACTION BY AUDITOR--
Assessed
Valuation
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Homestead
Valuation
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Approved: �l� •����'� Date: lv - Z 7' 7� '