Homestead_Doerner(�A�CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
/ State Fortn Sd73 (RB / 4-03)
Prescribed by Ihe Departmenl of Local Govemment Finance
INSTRUCTIONS: See revcrsc sidc lor Iilinq inslmc(ions-
FORM YEAR
{� H�c�o ��' �� i
Ji � �:�.�/ �� �y.ei�
APR 2
� �e) certifyntt(at'dnth i t�dayaLA7arcM�lQy
/ (:IGCr�..�f�htll�Ty an-•rr— 1
I(We) occupied as our principal place esidence Ihe following desaibed real property (or which a Homestead Property Tac�Credit is hereby daimed
❑ I(We) owned ❑!ve buying under contract
, Have a benefidal interest in ihe entlty that is liable for the property taxes on the pmperty and that owns the property or is buying under a wnVaG.
I( buying om m�tred. Fee Simple ownefs name
Recorders ofice where mnVaa is
Caunty
ramship
rar�i�uryqer�����I ` I agai unpiwn F /� � IlsNepro
U y !% � ! /
(_ �-/
If any poNOn ot Ne residenUal sWCture w Ne Wnd not azceeding one (1) aae Nat immetliatety wnounds that
ol Ne properry WI¢ed tn produce inwme.
County
To.vnship
I hereby certify the above sWtemenls are W e, coneG and complete.
(number aM sheef, cify, sfate, ZIP code)
�i S S-f-��.i�c- st.
County
0
Record number � Page
Raal pmperty ❑ Mo�ile Homo (I.C. 67.1-�
ve is used W produce income, desaibe the use anE portion
Twvnship
;.»,:a — -' � __v..v.�-- � � -
:� . �.s� :��_r�<.��'t�,�--�-rn.� �ic. ��s�=STAN�ARD.DEDUCTIONALLOWANCE,-,s_}"^�: ? +t3]='r_ .�+
�'�ki��-t '.��>�3a=:.�vd.�. �-�'`.Z�w��'t",7"�:�_�_
20 _ Pay 20 _
� Lesser of 12 Homestead S
Vawanon w 535.000
Signalure otluiditor ' . Date signed
J
�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
1167
SIa�E fMN!)M IIL /"�'1
a
IAFAS�IAfA Po0.V "�Sil.\
InJi��iJuaL auJ ma:riN couple� arn limi�td �o ore Iwme�aJ �tandaN J,Nunim. As �he rttcip� of thi> deduttion bcca�rcs
morc brneficfal, there is morc incer.mx chan ever (er homestr:nl fqud Nome'rcad frsud causes hi�hrr tas bilis (w all; therefae.
HEA 13�13-?009 requim uxpa�er.; Mho receire the hwnesiead siandard Jnfunion �u veriPy Ifw� �he} are eliciWc io recei.e ihr
benrfit anJ io prtw�iJe :ukliiiunal/'identiiying informa�ian nem'vrr ro allou� counq� ga'emmenl ro barter munitor humes�eaJ
filinfy. This in(ormaiion will 6e i�� conlidmtial mA can only h acmc.eJ 6y amhomeJ caunp� o(ficial..'Ihe Ikpanman of
Lceal Gm'<nmem FirttM'< ��ill �iac �his iniorma:ion co crcau rocrls that a'ill h:!p cwncv ufficiaL. diminaie homarcad hauJ.
, • , ' , , .
� Tazpaver Name Prnpern� Address
. Doerner. Brian J
52s 5 stout s'I'
Princeton fN 47670
Brian J Doemer
528 S Stout �
PRINCETON IN 47670-2532 State Parcel Number Leeal Description
I�I��II���I�II��I���III�����I�I�I�I���II���I�I��I�II��I��I��II � k z6-12-07-404-001.462-028 01e-o1462-ooMONROEHOMES22
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This form MUST be returned to County Auditor's office.
Please do NOT send this form back withlyour tax payment to the county treasurer.
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