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Homestead_DriscollCLAlAA FOR HOMESTEAD PROPERTYTAX CREDR/STANDARD DEDUCTION smm rv� s4rs (R7 i s-ob) Pra�bed by Ihe Depa6rent ai Lool Go�armaY Frar� �NSTRUC710NS: See reverse side far lding instructions. For� HC70 � _ . . . ; ..�:. .•.'r. s �•� � r.: ,J. �-- �. , . �. a:_. s" ' �.:.. ' ..' �.. ._ y1\.� 'r . ' . rE .e Yw ' 4 �y- . � (�'�e) certiy that 1st 20_ I(We) omipied as aa prrt�dpal plaa oF residence ihe "rg descrmed r�l properly far which a Fim�estead Prop� �i��by daimed: ��(We) owned ❑ Me byr"vg under oantrad �—py�,!, Have a benefi6al mferest m the enfily C�at is liable 6w Cie poperty t�ces m the p�opaty and tlat owns the poperry w is�g�r�a cantracL tt huyure on m+tracl Fee simpe w.riers ivr� (�,tirdds ot6ce whae carRrafl ia ieouded a� � .:.�xr..°,� .i...-..•� � . .>:x- ��- rnvrcnu�uwwr,nwa:;.� . - TunshF .. T�my d Wncl (dy mrvn, � � � , . .. . nvriber ��. legal de�a�Wm �� � _' Is tl�e poperty i vtion oF the reside�qial sWC�ve w the tmd nol mcceadnp o�e (1) ave Mal inma6eEely wnav� tl� ■aperty iEiFmd m piotluce eiaorne. Remrd numDer I Pege paperry LJ Mobib Fione (LC. 6/./•n ' uaed b produoa nmrtie. desad�e tha uw md porUOn y - > . j.• fiiY'i �ji£ �� ��YIC�TIM f i I�W GYVM�V� 4,f1WiC�l�GlWJ� � ~ ' . �� I���j•.�"ttJ N- ��, �y�. ASSEASORUSEOMLY � �i�, t`�._�� y�'� y��i, .-AT700XOF�TTV� E$ � � VALUE ��-� ,�v2i�r.0.�S�:V��.,�.A.�..na$�,tY'??F.�. .. �i.:• i.... t. <. .4.. �`.;r :�s., �..... „n,.r., , .,... '� i� >,Land rrot exceedng t(one) aae imr�diately ' _ a in� �, k�+� �' ���?� i q, �.i SWwnd� feSidefltial� C4. ��) '�'a���� r�t i���'`' �.'�ii�n�l' n8 impovErt=n `,s-�. +t �..:, i r. a.l�...u�!s A! O�her lard �2) ' -•'�tg)''': "� `.`�C�, � '��r'd,r{? �g,:,i; i," Tdsl land (lare 1 plus 6�e � �g) �,, e , ; ��� .� � ,y �� , t �ty.�4�C'. Resdential "vnprovecients ar Mrwally ��� �4� ": ., Yr.,.�,.�� �%e ., i�.»'.'�'✓.�:'(: b''._:tie:��� 0.SSas50d Abd7B / A1anu!acCaed Flort�e ��e (� � r� �'A�l;� f u�y���� jq9 �p d��'�llryy�,� .. 3,.n3,Y"�.�.�+�i 57,5 ��•...nl?`.,.+��?R: r •S�,-j� rt � .. Otlier improvemen� (6) . � • .n- ,;:`-v, ,r.,.; :.: : s Tdel unptwert�arrts (�vre � War� 6ne 6) C� T�I value (1'vre 3 pds Bne � (g) I tiereby certiy Nre above is true. mred. and sigr�ae otassaRV Dam signed ��. Yeriyirg adian' Sipmhsa N Audmr DaOe signed '.7 ; 20 _ Pay 2b _ Lesser oF 72 Homestead vaa,�nor� ar sas,aoo s � � Gibson County Auditor 101 N Main PRINCETON IN 47670 � FII,�D APR 1 4 ZO10 �a� ,a GIBSON COUNTY fIATEfORM!"MIR=/�MI MAStIRFFlO1tM.g1� T IY:A [E IC V 1.121l.1 InJiriJuals anJ ina:riN cauple arc IimiteJ to orc homc�eaJ vanJaN dMu.iion. As ihr rttcip� oi �his dcduciion beconres morc beneficial, therc is more incenmr fian e�er for homrsiead fnud Ilomnteazl fraud cau�es hi�M1er ux bills fur all: thercforr. HEA 13J-1-30(19 requires u�papcn aho reccirc the hanesteaJ sundard Jnluaion in verify tlui they arc eligiblc to rrcene �he benrfit aN to p�w'iJe �Yliti��ul iJentiirine information necr<vn� to allw� counrc ev�rmment ro bener monitor homrneaJ filit�5. Thic in(nmulion xill M AttY confiCeNial and can nnk M arctmreJ hy aminriuvi roumy o�Ticiulz �fhe Ikpanmem nf Local Gw<rnnrnt Fi�uirce xill uK �hi� intoemation 4 trcatt twls tha� o'ill h:ip eqairv ofiw9als dimiiurc homesieaJ fiaud. . • , , ' , . Taxoaver Name Prooert�� Address Driscoll, Patrick/Becky Patrick�— {��S` SIQ!'�A.i�� �C• PRINCETON IN 47670 � 11 I R S Prince S'f PRINCLTO\ I\ 47670 Stare Parcel Number Leeal Description ,Y 2Cr12-18-203-000.294-028 01s-oo2sa-oo SS ADD 59 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. r � efrs�l c�� r �� � K .� ig Address (numbcr nnd>vm�, ciry, state, end ZIP codc) � I I g�S f��� nl c e�-f - �� $ `�ecK� � S iilin� Addrtss (Number and atree4 cily, SWIe, unJ "LIP cude) ib' �S pr��Jc S cial Sccurity Numbtt (last 5 dieits) Drivcrs Liccnsc/SUtc ID Niunber (laa 5 digits) -- - -- Oiher(plesst Othcr �r'rs�o l� ��nmc as pmperiy addles.i �,� ��c ?o v in 1'art 4 brlow) I, �r�s��� f-7 c.,me �s pmprrty address LS Pert S A,9ow) . idersignecl certifies, under penalty of pequry, that the abovz and foregoing infortnation is we and correct and that he or she is elieible to lhe homes�ead standard deduction on this propeny. Each undersiened al,o understands that, by claimine additional homestead deductions illy, he or she may be liable fnr back taxes and substantial financial penalties. s��r� � -/�_ivl