Homestead_DewusFORM HC 1� 1979 � To & FiIM in Duplicate
PreuriUM By Sta�e BwrO of Tax Commissioncrs
CLAIM FOA HOMES�AD PHOPEHTY TAX CREDIT FOR YEAA 19� �
��\ EE BACK FOR FILING INSTRUCTIONS O/Q- �O(Q.Z(Q� OO
�We) �-/ �- certify that on the tst day of
�.,arch, 19�, I, (Wef occu 'e a our 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 i erest in the taxpayer
Property Description in ���-�-� County ���� Township
Taxing District (City, T�): �-+-�-w���-�
Parcel Number or legal description shown on tax statement:
�..�,�- ,(�-�."Co . % d� i/ �l.
If buying on contract: Owners name �'� ""'°1e
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: County ' Township
�
��
�- � hereby certify the above statement is true, correct and complete
'���, ,_ .� �
AdOr¢ss
Ci�y. State ana Zi0 �e
h�%4 � U
' 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
T�otal Land � � � � � 't" �'"y
Residential Improvements ���ty � t979 Dwelling
Ga ar ge
�, ����a�Q� Total
Other Improvements // AUDIT�R �
�' Improvements - Line (6) plus (7) equals (8)
by certify; the above is true. correct. and complete.
OI A552zs0�
True Cash
Value
(il � �/ �o
(2) —
(3) o2i Y 3 0
c4, i�=�-a
�s> 30 0 �o
(6) / �a
(7) —_.m'� :
(g) -5- t�
Assessed
Valuation
8/0
o �
/r/,%��%%°
�/�///%%/%
;:.,,:-ii;.;;:i
—_--
�
: •
� _c .
Homestead
Valuation
�-�y-7y
Da:e _
- ACTION BY AUDITOR -
� Date:
Gibson County Auditor
701 N Main
PRINCETON IN 47670
�
tlAlE f00.\i!) W IIL'/ Yw`I }R£�SVFLA Po0.N 11A
PALYRIflmBT
InJiciduaL. anJ mar�inl coupkti arc limi�ed io orc hnmes�caJ ,undanl �edu.iion. As ihe reccip� ot �his deduction h�cnmcs
murc bcnrficiaL �herc is morc incrntne tlun ecer (or humesrcxi fquJ. Ilomesttai frzud causes higher ha bills (or all; thereforr.
HEA IiAi-2009 requin�x laxprycrs who receire ihc hanestead standarJ �krluction in .eritr tM� �hey are elieiMe to mcene tAe
benefii �nl b pnn•ide a�kliiional idrntifi�inc in(wmation nece.'vn� to ellw' counn� gmrmmrnt to N_ner momtor homutzaJ
filin�.�. 71iis inlnmu�inn will M Aryu mnliucntial and ran only h acce.cud b� amharieed rouni�� o(fitiaB. The fkpanmcn� of
Lucal Govemmem FiiuMe will u.c this information ro crcate Uwls �hat x'ill h:lp cwnn� o(ficials elimi�ute Iwmes�<aJ Fraud.
, • ' , , • .
Taxoa��er Neme Prnpert�� Address
Dewus, Iris
474
Iris Dewus
304 6th AVE
Princeton IN 47670-1037
���n��iii�i��ii�u����n��n����iiin��i�ui���iin�n�i�i���
30� 6�h A�'1?
1'rincc�on I\ d7670
State Parcel NumAer Leflal Description
X 26-��-�2-�O1-000.626-028 019-00626-OOTOWERHGTS184PT
1
Owntt 1 First Niddle Lul
ZR�S P. l�Et�US
= Address �num6er m�d �veet, cirv. sta[e. and ZIP code) � Snme ns p`upem ndu�ev . ". ...
J� O i�- �Ti-1 . �i E . — � '��% � b
Soc¢I Securip' Numbcr �6st 5 digiLS) Driva's Licensc/SUte ID Nmnber (IaU 5 digib) Otha (plcise speci(y in Part 4 beiow)
-
Spou;c First Middic Latt
W 1 0 �-1
Ma� � e Address (Number and stree4 i)', smle, anJ'LII' wik) �$ame u pmperty add�s
Social5aurity Numbtt (laa 5 digi�s) DrivcYS Liecacd5[a�c ID N:unbcr (I�s� 5 digits) O[hcr (plc�cc specifi� in Part S bclow')
so¢
� � � �
Each undersitmed certifies, under penalry of peryury•, that the above and foregoing infortnation is we and correct and that he or she is elieible to
receive the homestead standard deduction on this property. Each undersi¢ned al;o understands that, by claiming additional homestead deductions
- unlawfully, he or she may be liable (or back taxes and substantial financial penalties.
Owncr 1 Si�mnoae Ualc 'I'elephonc
� /� �--�a-�o ($
Spouse Sigumre p3i� Tclephone
(... )
1 � � �