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� S[E BACv FOR FIL1tJG ItdSTRUCTI0h7S _ (/
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I, `.,,;�) , • �rtify that on ttie lst day c
i�'<�sch, 19 , I, (P7°) occu?� ed as our princi olace of residen� tf�e .fo'llo.�ing des¢ib�d real �
nroi:�rty �or �•;�71CY1 �4 I���SLA�1 Pm��ty Tax Credit is tierel�}' b�.ing claiurcsl: �
I,�,�T� � � . �`� I
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� are-bu-�inct urder contract , � 0�.�''-Ob��
� hayz a b°.��°ficial in st in �he t��ayer '
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F�t^_rt�� I�scrip:ion.in unt� 'lb,:ii:lii'
'i'a�;ing Discsict (City, Ta�n, _ ��anstuo) : 1 / t R'Y�� I
—� �Pescel ih.u��lr.s o legal d crip-�on s}xrim on tax stat mst: �
�,�.- �- . �- ��
S' bu_;in� on o�ntra�: Own_ss nan� (fe� sinrole Q•ms) f
Co�tract r�ord�i in P°�rd°r's Office - P�nrd Pb. Peg° '
I_` ��y mr`-�ion o� the resiciential su-ucture or �ie land, not e>�e�iing one (1) acre t}�at �
i-�n:^c3iately slsiviur3s that structure is useri to produce inca�, describe t��e use atr3 eortiai of �.
�i7e p�oG�sty u`ilized � ora3uce incorre
r�ny other wwz=ies in which individual cr:�is or is bvr�ing real prop�sty: �� . 717.•�islu�
S h:s�y c:s`iiy the ak�ov�z stat�rnnt is true, mrre�'t an3 cor�lete.
�/ � `'> o �- " cr�-, h--�-u-� 7 �
�iQ��e Street Ic'iiress Cit�, State air3 Zip C
*Indivic � or is �uying uner a mntract tkyit provic3s he is to pay th_
D,-orr�����esid��ce, or }�as a ben_ficial ititsest in t}�_ ta�:f�Yer.
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�EC i � �ga�
- FOR ASSESSOR S USE Ot'�LY -
L�yr1 not e�cee�t� � e�n�r�ciiately
su: rtvu-tling residyn i,-��ro��ents
otti�r �L3rul �
7'otal Land
Pesiciential Inorov�rents A}°elLing
(1)
I2)
(3)
(4)
Garaae (5)
Total (G)
Tn,� c�n rUS�ss� }���st�.::�
Val� Valuation Valuati^_E
O`_h�- Inroroven��s ��� —
'1� ' u���ov�rtints - L.i.ne (G) plus (7).Eauals (E3) (8) _
h--�r ,LL�-'-i: v_ � r r.Ib� GL771C)�.et°.
l� �� �� ,�: _v the a1x�`-= is true correc`�
���na�ure o� ?ssesser
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
n
3726
Harold L / Juanita Eggteston
505 Linwln
Princeton IN 47670
y/��o�0
Addrcss (numbcr and ->ttm, ciry, sta�e, and
InJiriJuals and �na:riN couplc ace Iimi�ed to nnc hnmc.acaJ AandaN JeAunioa As the rcceipt af �his doduninn bttane�
more bemficial. tMe i> morc ircrnme than r�er (or homote:rl ifaud. Home�ead frzud caascs higM tac bills for all: thertfae.
HEA 13i1-?OW requim uxpa.ers who receire ihe hanesimd <mndard Jnluc�ion to .erilY ihat thq� am clieible io reccice �he
brnefit anl �o p�m'ide adeli�ional identifrin_ infwmation Mcc:vey to allw' counn ro:rmrtm� �o bener rtnmiNr hun�estt:d
Illinf,�.'lltix infnrmLim will M{.eFM conllucmial anJ �n nnly h: sre�uvl 6� aminrvni rounh� nlTitinl.�.'ITc Ikpanntrn� of
Imal Gmormnem PinaM'< will u�e thu mfonnmion W<ream ¢vin Uut will h:lp cnmro otTxiaLs elimiewh Fam<9ead fraud.
. • , , . ' .
Taxna�•er Name Prnoertc Addresti
Eggleston, Harold L / Juanita
�� yo D
3av� ,L��/✓Co� N /f-YK� �RINc E%
Kial
State Parcel Number
x 26-12-18-103-000.737-028
—�Nhd�IT� I /�oRRl,iiNE
�,ailin_� Address (NUmber and svee4 riq', stale, and "LIP cqk)
sa� � i �,v�v � N ��k , /��PI�N� � To �/ � -�Ai �
xial Sccuritr Numbcr (last 5 digiLC) Driver's Liccnsc/S�are ID Nwnbcr Qatt 5 digits) Othcr
i05 Lincoln
1'rinccton I;. i7670
Leeal Description
019-00737-00 BALDWIN HGTS 2 BLK 4
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— - . I�.' Snmc as pmperty oddicv —' "_ — '— . _
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ID�euc sutcifv in Part 4 below)
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� $:vme az pmpe�ty address
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undersigned certifies, under penalty of perjup•, that the above and foregoing infoRnation is tive and correct and that he or she is elieible to
;e the homestead standard deduction on this property. Each undersiened also understands that, by claiming addilional homestead deductions
,fully, he or she may be lizble (or back taxes and substantial 5nancial penalties.
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