Homestead_Farris (5)FOFM HL 10 1979
Reuri0e0 By $ta�e 9oai0 0� Iaa Commissfone�s
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR.19��
io Be Filea in Duolicate
✓
SEE BACK FOR FILING INSTRUCTIONS OrC�� A���O. OO
��` We
� certify that on the-tst day of
���arch, 19�, I, (We) occupied as our principal place of residence the following described rea� property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract
❑ have a beneticial iry�t�erest in the taxpayer
Property Descrip[ion in ,YEc�3 Counry ��--�. Township
Taxing District (City, Te+v�ewaskri�: _ � _ ,
Parcel Number or legal description shown on tax statement:
�� 9
If buying Ofl contract: Owners name ��� simple ownep
Contract recorded in Recorders Office - Record No. Page
If any portion 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 above statement is true, correct and comple e.
�. / � � � . ' �
�U..�t� J 7
5. nawre � Screet Aooreu G;y. Sca�e ana Zio Caae �
' Individuai 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
ootal Land � �°' � � �
Residentia� Improvement�UN 211979
(/T .� /��ti��
Other Improvements AUDITOR
'D
True Cash Assessed Homestead
Value Valuation Valuation
(�) /�S`a Ss—o
12) `
(3) % (0,5"0
Dwelling �4� �
Garage (S)1o99� ��d
Total (6� �
Tr Improvements - Line (6) plus (7) equais (8)
I�oy cer�ifq� the above is true. correci. and complete.
Signawre oi nssesspr� ��
SS'�
�
(7) — —
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- ACTION BY AUDITOR -
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6-�3-7y
Da:e
Date: CL
Gibsan County Auditor
101 N Main
PRINCETON IN 47670
3097
I' = �
iYlASllRfl I�RV �SIA
T fP:A¢CE ICH.4'4.1
IndiriJuaL� anJ nu:�icJ muplc.c arc IimitN to onc homc�c�J uandnN JNu:uon. A> �he �iceipi ot ihis daluninn beconces
morc bcneficial, thrrc i. more incenme dun e�er for homr'te:yl fraud. I IommraJ fiaud ca� hi;her tai bflls fw all: therefore.
H6\ 13+3-3009 requim u�pa.crs �ho receire ihe hanatmd standard dNunion m.erify �M� �he} are eli�iNe io mcene �hc
brnefi� and ro pn»'iJe aAAitiunal iJemin'in_ infwm:niun nemsary� ro�Ilw' counn' gv:rmmrn� �o MI¢r moniwr homestt�l
61in�.'ILi. infomuuinn will be Arry mnliJemial anA c�n nnly M acce:+eA hy awMriicJ rounry offiaiulc The Derynnrcni nf
Lmal Gmcrmnrnt Pinancc ��fll u.c Ihis in(ormatiun W<rcatc twls �hat will hdp counn' ot%als diminurc homnicaJ Gaud.
. • , ' , ' .
Tasna�•er Name Propertc AJdres+
Farris, Fred IsaadBetty Jean
Fred I Farris
704 S Prince
PRINCETON IN 47670-2624
I�I��II���I�Ii��l���lll�����l�l�ll����l�l�l��lll����l��ll��l�l
7oA S fkincc 5'I'
Princemn IN -07670
State Parcel NumAer LeQal Description
2612-07-403-000.770-028 01aoo77o-0o SMITH ADD 9
- - - ✓- -- — - --- - -- - — - --
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Ou�na I
ig hdL`css (nu-`xr ard s� cip�, smte, and ZIP code) � Same n5 propem address.
7o'f 50�-�-� P2,.��c �� P�,,J��-o,� �a 4��7�
Sceul Srcuriiy Numbcr (lasl 5 die�LS) �hivds Lictnsc/Sum ID Nmnber (la.t 5 di�its) O�her (plpse specify in Part 4 below)
�
Spou;e First Middle r �—Lvst
�; � � �eFl,� rr���s
Mailine Addrtss (Nwnbrr anJ svee4 ciiy, staie, and ZIP cak) � S:une ns pmperty ad�
%o� �ouTi-1 �2�,�cC S� �Qln�CEio.� i�u �-%7�Za
Social Sauriry• Numbcr (lazt 5 digicc) D"m•cr s Limnsc/Statc ID N�un6cr (la t 5 digiLS) Oihcr (plc1sc spcci(y in Part 4 bcior•)
, . �
Each undersi5med certifies, under penalty of perjury•, that the abo��e and foregoing in(urtnution is we and coirect and that he or she is elieible to
receive the homesiead standard deduction on this property. Each undzrsiened al>o understands that, by claiming additional homestead deductions
unlawfully, he or she may be liable for back tares and cubstanrial financial penalties.
Ow'Mr I Sienaturt Da� 1'elephone
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