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Gibson County Auditor
101 N. Main Street
Princeton, IN 47670
FIL,ED
— APR 9 2012
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GIBSON COUNTY AUDITOR
2303
Indi�'iJual> �nd marrial couplc` a�e limitd m one honws,md ;mnQUd Jeductiun. A� ihe receiM �f :hi� dttluc�iun becomo
morc bcncficul, iFr.�r. is mprrc ir,crnii�e �han cccr Inr hoim;.0.nJ GauJ. ifamevcad @aud cau:c� hichcr m� bil6 lor all: �tnrcior.
HIs� i;a»-�aw r���� u�o��r� �n�, r�:h�z ;nr ho���.m�d .�anJacl deJuction m ceri(y iha� ihey a�e eligiMe Io �ttri�e �he
0.�ncfi� ami m prm�idc aidi�ional idrntifi'mg ir,ICxnvviun rrc:cssan� m alk�w coumr em'cmmcm ;o bamr m+niior hoRC� yA
filinu. Thu informmim will be Aep confiJentiai end cin onk br :nYlaed br aufiurrzeJ mum� oRicu6. The Dcpanmm� o(
Local Gu:crr.mrm Pinancc .. ill uac ihi, in(orma�ion m cruyir mol; chat uill hclp munrv olFcub ciiminit. homotcad Gaud.
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Taxuaver Name Location Address
Donnell, Patrick Shawn
209 ZIMMERMAN OR
PRWCETON IN 47670
Patrick S Donnell I II�I�III��III �II�I II II�II��III�I�IIIII��II�II�II�II�I�II �II II I��II�II�I�II lu II
209 Zimmerman Dr
PRINCETON IN 47670-3335
'I�III"'�II��I�IIIII��II'������I��'���"'lllll��l�ll�llili���l�� StateParcelNumber LeqalDescription
" 26-12-06-203-000.185-028 HILLS & DALES 3
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
1kTi�Ck I �•� I 'ldAnell
Addrzss (numbcr and svctL cilp, sta:e, anJ LIP code) � Same as propenr add-ess
� Z� �n m<�t �+'i cy� � �rin 4. fiT� �/ r-{ � G.-] O
surin� Number Qss� 5 di=i6) Drirds l.icensc/SCate ID Vmnb�7 (las: � digis) Othv (plcasc spccify ir,
� su�
r-�rs� M;aai� -
Addies� (\umher znd s:reet, cily, s�aV. and %IP codc) � Samc as pmperry add.ross
Sccuritv Numbcr Qast i digits) � Drivds
5nrc
Othcr (plcasc sp:cify ir. Pan 4 bclowJ
undersiened cenifies, under penalty of perjury. that the above and foreeoing informntion is we and wrrect and thai he or she is
� e ihe homeslead s�andarcl deduction on this property. Each undersienal ako �nderstands lhat, by claimine addi�iunal homestead
;(ully, he or she may be liable (or bacA ta�ces and substamial fmancial penalties. '
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to
R, CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
Slate Fortn SC73 (RB � 1-pj)
PrescnEed by the Department d Loca� Govemment Finance
INSTRUCTIONS: See reverse side Ior liling insVUC(ions.
�o-� FORM YEAR
�i-.rHCUO� � M'�"..
� X 1� i�✓ Ji�.,.:�
Aj���
� �' �) �J�� IX10 � '' � r u� n
� �e�, u°— - � � certity,ihat.on the.7s�'day�of�March,�20
�I(W occupied as our principal place of residence the following described real property for which a Homestead�PropeFt'y TaoCFedit Is�h y ai tl
(We) owned ❑ !ve buying under contrad
, Have a benefidal interest in ihe entlty that is liable for the property taxes on Ihe property and that owns lhe property or is buying under a wnVact.
I( buying on conirad, Fee Simple owners name
RemNers ofim where contracl
Counry
number
Twvnship
Legal
H any portion ol lhe resitlentlal sW qure or Ne land not exceeding one (1) aae Nat
o( Ihe properry utilized W produce inwme.
Record number
rowr; (owruhip)
Page
I Is the pmpery in qu ':
eal property ❑ MoWe Homo (I.C. 67.7-7)
surrounds that sWCWre is used b produce income, Cesaibe the use anE poAOn
�"V$:.� +�i<�'t'�+..�•s'r�.";'.f-.,r� `:.—>z v..+'�t T s x..«.c �"9�a -t . .
�ASSESSOR�USEONLY�>����''�"�" TRUETAX ASBESSEDVALUE �HOMESTEAD� NON-RESf�ENTIA� i
"� �- r ����.��k»� �YAI:UE�� =`ATx100°/a OP'TTV '�`'�VALUE ��VALUE�ri�*�.,'r` �
{.� +�' . ..-.�SY r.��rt.-'.�2�n.�. �..a�.o -� iF-�i.ti#4�-„. ,.�� ���� 3��
Land nol exceeding 1(one) ape immediately (' � �� w,:'a��3-..�-b�,�3 �-}S-`�
surtounding residential improvemenLs. ;g„}�� ��,_,rµ.���
Other land ��`��"''�� � 4 �
�Z� i'�ii.`�=._�a;.4-� -
-��,..,'Sk --�
Tdal land (line 1 plus line 2) (3�
�( .'4.y>F-�-06'YYiF}y/j yl �sv�i
Dwellin "`" —�
Residentiel improvements or MnuaOy 9 (4) ����'`�����..���+�����"�
Assessed Mobile / Manufactured Horrre Gara e 4a ., r.' �� �"�'�-���:
9 5 .� ����,.'`�� ��_ _ �"�
( ) �`.a���_�•:. %���-..�+...
�, ., ,.;�=��
Other improvemenls (5) ��. �-¢.,.
ya�; �hi:r .�xe.G��
TUaI improvemenis (line 4 through line 6) (��
Tdal value (line 3 phs line n (g)
I hereby tertify �he above is We, corred, and Signature of Assessor . Date signed
wmplele.
Verilyi�xj aclion - Signature otlwdiWr Date s' neA
5
''�i ����-��T���i'4?.'Y�,_vs��'�.:ST/WDARU:DEDUCTION'ALLOVIIANCE`�,�L�;,+g ;4a',�,��-s:kv r����,b,`i71"�1�,�„�'._�
20 _ Pay 20 _
Lesser W 112 Homestead S
Vauatwn a E35.000
Signature oflwdhor ' � Date signed