Homestead_Cox (3)FOFM HL 70 7979
PreuriGeE By S�ate BwrE ol Tae Commissioners
CLAIM FOR HOMESTEAU PROPERTY TAX CAEDIT FOH YEAR 19�9
Ta & FileE in Duplicate
/
SEE BACK FOR FILING INSTRUCTIONS Q�%�-0044�• O'O
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(We) "��• -��+�*���� a� certify that on the 1st day of
arch, 19.—, I, (We) occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) �ned '
❑ are buying under contract
❑ have a beneficial interenst in the taxpayer �
Property Description in /r_[6S�i County '�P�Ue�7.� T�
Taxing District City, Town, Township): ��� e � T�
Parcel Number or legal description shown on tax statement:
� �T,Uu3�`C,c �[oo r .27� /7-2 /O . 3Zc.4�2�
If buying .on contract: Owners name ��� simple ownerl
Contract recorded in Recorders Office - Record No
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 complete.
�
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sneei naa,ess
County Township
���, � . `f7G 7 0
J[ate ana 4p GoOe
' 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 ONLY -
Land not exceeding 1(one) acre immediately
surrounding residential improvements
Other Lantl � � � � �
Total Land
Residential Improvements
JUL 3 ? 1979
Dwelling
• Garage
///��Total
��
Other Improvements '
T�' Improvements - li e(6) plus (��g (8)
I�by�eftr�y the above is �ye. correct. and complete.
Signa:ure
True Cash
Value
(�) /3$�
(p) " ° �
(3) /3fr �
Assessed
Valuation
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- ACTION BY AUDITOR -
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3aSS1
Homestead
Valuation
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Approved: ����t�E7 oate: 7- 3I 79
Gibson County Auditor
101 N Main
PRINCETON IN 47670
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PU4[AIPFLOYi�II
nr.vsuR[xrox�g�n
IndiciJuals anJ nurriN aouple arc limiud w onc Mnmucad aanJZN Jnluniun. As ihe uccip� 01 this daluninn Mcomce
more beneficial. thrr< is morc incen:ne th�n r�er for hunx>te:¢I fquJ. IlumeseaJ frauJ causrs hi�her tax bills (or nIC [hemfwe.
HEA 13-b1-?fH19 rcquims uxpa}en �'ho reccive Ihe hanes�mJ 9anda�d deJuc�ion m verily �lu� �hey are <IifiNc lo mcci�c the
brnefit anl to prtw�id< aiWiGunal idenuirinc infwmariun Mcr.vry ro aliw' counp� grnemment ro N�rcr muniror homes�eal
filin�,�.'Ihis inlormaiinn w�ili M1c Aryv crnlii!auinl aml e�n nnly Ir. acroseJ b)' autlnrvni rounn� n(TiciaL�.'1'M1r Ik7vnnxnl nf
Taxnaver \ame Prooertc Address
Cox, William R/ Linda J
910 S Adams S'f
Princeton I� d7670
3588
William R/ Linda J Cox
910 S Adams ST State Parcel NumAer Leeal Description
Princeton IN 47670-2702
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(numh.-r ond itmt, city, statc, end ZIP
Securii} Numbcr (last 5 dieiLS) Drivds Littnse/State IU Nmnber (lut 5
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First
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� Addresi (Number and avtt4 �ry', staie.:+nd'LIP cale)
D"m•crs Liccnsc/5tatc ID Nmnbcr (lac� 5
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Middle
(Plcasc
as pra�crty addrec; -
� S:une:s pmpem adJrea�
undersigned certifies, under penalty of peryury�, that the abo��e and foregoing infortnatiun is we and correct and that he or she is elieible to
:e the homestead standard deduction on this propeny. Each undersigned al;o understands that, by claiming additional homestead deductions
.-fully, he or she may 6e liable for back taees and substannal financial penalties.
� /ig�pi�. — � , Uem 7'dcphonc
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