Homestead_Elliott (2)PORM HC 10 1979
Preunbe0 By State Boa�a al iax Cammissioners
� (We)-
� arch,
which a
To Be Piled in Duplicate
CLAIM FOR HOMESTEAD PROPERTY TAX CREUIT FOR YEAR 19�� ,/
O��i-00�3 �-00
SEE BACK FOR FILING INSTRUCTIONS
�T• ���-y�g�- '�U�����t� ,�= certify that on the 1st day of
(We) occupied as our principal place of residence the following described real property for
1 Property Tax Credit is hereby being claimed:
I, (We)� owned
❑ are buying under contract
O have a beneficial in�ter�es�t� in the taxpayer �/
Property Description in�X�Lr.%2-2-or� County ��-f'--�e_� Township
Taxing District (City, Tnwnr Tswnsbi�): /�/Li��c-Ao�r-,-,
Parcel Number or legal description shown on tax statement:
�oZe.�% y°a,�� 3 s��/���
If buying on contract Owners name ��� simo�e owneq
Contract recorded in Recorders Office - Record
If any portio� 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 aboce�tatement is true, correct and complete.
�
'Signamre
5 �eet Aa�ress
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ana
y���
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
Other Land � Q � � �
Total Land
Residential Improvements ,�, � L � �o,�c� Dwellin
9
Other Improvements
Tn �� Improvements
I�by cert�e
.
Siaiwwre oi Assessm
Garage
�����`���tal
�
AUDITOR
- Line (6) plus (7) equals (8)
above is true. correct. and complete.
(�)
(2)
True Cash
Value
i r I
Assessed
Valuation
� 70
Homestead
Valuation
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oa�e
Date: —� � G
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
763
SIAiE IOR.\I �!W Ul'/!�MI
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iPL.lNAfltfOAN11n
InJi��iJuaLs and ina:riN coupl� arc limitcd Io onc homeueaJ 9andaN J,�luniai. As ihe �ttcipt ot Ihis deduc�ion bttomes
more bcntficial. thrre is morc incentnr than e�er (or M1omestexl Baw1. Homarcul f`aud causes h�her tat bills ta all: rhercfine.
HEA IS�f-?-?IX19 rcqu"vn u�papers xho remire thc hdnestead s�andvd de�iunion m.erity �hm they am elieide �o rtcene �he
benefit aM to pia'ide adfiiional identiiyinc iniormanun nemsan io allw' counrc em'rmmmt ro b:tmr mmlror homesrcaJ
filing..'Ihis inl'nrma�ion x�ill M Acpt cmlideniial and can nnly t+c arrec.ed 6. awlrorizeJ rounrv ofLcials. TM1e Ikpanmrm of
Lueal Gw<mment fi`ucee will u�e �his inionnation w crcam �wls �ha� �cill hdn ��Y offieial. dimiwte homcstead Gaud.
. � � � . �
Taspaver Name Prunem� AJdress
Eiliotl, Duane A/ Devona R
llzuat�z. � i 3� w�,� s�'
Princcton IN d7670
Duane A/ Devona R Elliori �� ��.�'�Q -aa—/ y
713 N West ST State Parcel Number LeQal Description
Princeton IN 47670.1441
I�I��II���I�II��I���III������II�I��I�I��I���II���II��II���I�II xZ�iz"07-102-000.738-028 Ots-oo7sa-ooFORESTPnRK3aPTr�SPT
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.
�� �
Oxn<r I First Middi< Lut
�Fvonl �L�ioT �
g Address (number wd svcet, city, stetc, and ZIP code) � Sume as properrv eddttsi
7/3 �V � T 5 i
Social Securih Numbcr (las� i dieits) Drivers Licrnsd5tate ID Nmnber (la.� 5 digiLS) Othrr (plcuc sptciF in Part 4 below)
Spouu First Afiddlc last
Mailin� Address (Number and svtt4 ciry�, sta�e, and Zfl' cale) � Same al propeny add�s
Social Security Numhtt (Iar.S digits) Drivds License/Staee ID Niunbe: (It;t 5 digi6) Oeher (pleate specifv in Pan? Mlow�)
5¢Y
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Fach undersiened certifies, under penalry of perjury•, 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 undzrsi¢ned al>o understands thal, by claiming additional homestead deductions
unlawfully, he or she may be liable for back taxes and substantial financial penalties.
O�.ner 1 Sibmawr< Uate Tcicphonc
�� ro �
SpouseSip�am:e je Tcicphonc
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11 1 �' 1