Homestead_Smith (28)wRn+ xc io ism
PrtunOea By $Iaie Baard ol iaa CAmmissfone4
CLAIM FOR HOMESTEAD PROPERTY TAX CREUIT FOR YEAR 19 7 9
io Be FileO in Duplicate
SEE BACK FOR FILING INSTRUCTIONS
�� (We) �� ����--L-�^--t 'I �� ��� certify that on the 1st day of
rvlarch, 19�, I, (We) occupied as ur principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in �^^
Taxing District (�ity—�ewr,rTownship):�
Parcel Number
If buying on contract Owners name �'� 5inip1e °wne9
pblo -018 alv
O� Township
or legal description shown on tax statement:
Qd�.NL[1��v-NE�i� 3>-�-.o (/•S�+)
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:
the above statement is true, correct and complete
1-��(� �' S�o _ �r� �
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County
Township
.� �/ .n /�
l�i5i,.. n., �v.,.. �`�-�-�a
/ — - Snee� no�r€ss / � � f ' Giiy. S�ate ana Zip Coue �7�
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Individual either owns or is buying under a contract that provides he is to pay the p�operty taxes
on the residence, or has a beneficial interest in the taxpayer. .
Land not exceeding 1 (on
surrounding residential im
ootal �and -��P�21. 19%9
Residential Improvements� �
ing
, � ^�'a(�ge
AUDITq�al
- FOR ASSESSOR'S USE ONLY
�� � �L., �� �.�
Other Improvements
T�'-' Improvements - Line (6) plus (7) equals (8)
I�y certify the above is true. correct. and complete.
Sgnamre oi Assrsme
.,
True Cash
Value
(i) _ So 0
(2) °�-
(3) 'f--�_
�a� a9��o
(5) —
(6) � 9=G o
(�)
�8� a9��o
- ACTION BY AUDITOR -
Assessed
Valuation
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Homestead
Valuation
/ 70
%/�%/%�/�%%%///i
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
�
STAiE fOF\Ul]rv 1R'/ f+ro
���Nm'En BT �T1TE BIMPO11f MY�It\T(:V r
i
M. SIIIfAlO0.M11.�
InJiviJual> anJ tnuriN <ouples arc limiied to ore homewead �andaN �4dvaion. As �hr �mcip� of �his dNunian becomes
more benenciaL �hne i. morc incrntnx dun ever for M1omestead fnud IlomesttaJ :raud causes hi�her ta� bills (or all; themfae.
HEA 13�13-�IN19 requim mipa�en who receire the hanes�mJ standard JeAuniun to raify tha� �hey are elteiNe w mcei.c �M1e
benefit an1 m pnr�iJe a�klitiunal identiirfrc: inform�tion riecr..'vey ro allw� countr gmxmmrnt to Y.IIer'monfror homesieaA
filin�.�.'Ihis inlnrmaiion x�ill he Aa�v crntiCauinl and an only fc aare: �n1 M1r auilwrized aounty oflivialt �TM1e Ikpannrcm of
Local Gmcmmcm Fifu�rcc �vill u.c this intomw�ion to cr<atr wuis �hat �vill hdp cv�mn� oFtinaU climiws hom<sicad Iraud.
_ Taioa�•er Name Prooert�� Address
Smith, RobeR J III 3�39 S���'%� �1!'
— ���
— �
Prinreton IN 47670
—__ __ —_7091' ---_' '__.__ —_ _ _ — _ — — —_._'_ __ - _—� —_ . .�" '- .
Robert J Smith III
3010 S Old US Hwy 41
PrincetonlN 47670-9206
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State Parcel Number Leeal Descrip�ion
2612-32-200-001.806-027 ��18otio0 aT NW rJE 32 21019.91 AC
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Owncr I First Middlc ! LaSt
�JN.fi� �. Jrni i'{�� I
- - - -- - -- - -- - - - -
m AAar¢s (numtier m�d ittect, cm, s�fltc, and ZiP�cotie) �ame rt pmpem aaa�s — �
3010 S OLb US If l.�'/ y"1 �f �'� ��eto� ZNLl7(n70 � �
Social
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S�wuce First Middlc ! I.sst
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Mailine Address (NUmber and strcel, �i�y, s�ale, nnJ ZIP caie) � Same az propmy add�, j
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Social Securin� Number (lazt 5 di¢iGS) Drivers LicencHSUte ID N�unber (last 5 digits) O[her (pleace specify in Part 4 below)
svx '
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Fach undersiened certifies, under penalty of pequry, that the above and foregoing infortnation is we and cotrzct and that he or she �s elieible to
receive the homesfead standard deduction on thii propert}•. Each undersicned also under>tands .hat, bp claimir.g additional homesteid deductions
unlawfully, he or she may be liable for back tares and substantial financial penalties.
Spouu Sizmaturt J gic Tcicphonc �
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