Homestead_Davis (14)�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
2880
41iRffMN!)'MIR�/w'1
mrwsut[x waw �-�n
IndiviJual. anJ �rtvriN couplec arc limi�ed io one homeucaJ �tandaN Jnlunion. As the rcceipt ol' �hi> dNuctan becm�e�
murc brneficial. tMe fs morc imm�tnx tlun e�er for M1omesrcaJ Gdud Ilom vcad frauJ causes h�her m bills (w all: ther<fare.
HEA 134-i-2IXMJ rcquirn uxpaycn rho rcccivc �he hanes�caJ slandard Jttluaion to vcri�y Ilut tAey are cliGiMe �o recei�c �he
benefit ani ro pnw'iJe a�Lliiional Wentiiyinp infommtiun mce.san� ro allw� rnunn gm'emmem �o be�mr monftor homesxaJ
lilin�.�.'IUis inlmmalion will M AryM conlidcminl nnA nn nnly M� arcr: uA Fy aWMrizcJ rounly n1T¢i;dn. �fhe Ikpanmcm of
I�cal Govcmment Pinantc wfll u�e �his inturmation m arcam 4vls iha� will h:lp camK ufficiaL. <limifm�e IwmnrcaJ fiaud.
• • ' , , , .
Taxoa�•er Yame Prnpert�� Add�ess
Oavis, Jerry L/ Patricia L
Jerry L/ Patricia L Davis
516 W Pinkney ST
PrincetonlN 47670-2356
I�I��II���I�II��I���III�����I�I��il��l�l��li�����ll�ll����ll�l
rl
J�
city: stste.-and2t P coEcj
5i 6 GUe 5
I Securiry' Number (last 5 d
��
'R?,e�c � R� I
e Address (I�umber and svee4 ciry�, sule, and "LIP cak)
5l6 i,t>e f f�inKne�.
Sccurirv Numbcr (last 5 digiu) Drivcrs Liccn.sc/Statc 1 P
$
�
5
YR- C� �o N L ,
� Other (ple�se speciF in Pan 4 below�)
cs
n��aai�
L• (�R V r�
� s�,��,� P��,� �a�
��ir>�z�o n Z�N
� Othcr (plctsc spcciC�� in Pan � bclow')
� 767a
70
idersiened certifies, under penalty of pequp•, that the abo��e and foregoing infurtnation is we and cormt and that he or she is eligible to
the homesiead standard deduction on this propeny. Each undersiened al;o understands that, by claimine additional homestead deductions
ilh�, he or she may be liable for back taxes and substantial financial penalties.
� /� -�d
( �
, /� /� �_�
-