Homestead_ForneyGibson County Auditor
101 N Main
PRINCETON IN 47670
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YAFYAILm�Y PI! DE�.V(1NEfI(F LIMAL C-0�iLVMFM iP.l4fP H'41.I.1'!.I
InJividual> anJ �rt�:riN coupb are limimd to nnc homc9eaJ aandaN J�tlunitm. As ihe �ttripi ol �his dNunion bcconrec
more bcnenciai, thrre ti morc incenme than aer (or homnrcal fraud. Hom veaJ frzud causes highrr Iac bills tw all; �hr¢;ore.
HHA 13ii-?f109 requim uxpa.ers who reccire thc hanestead swndvd JNunion a.eriiy tlut thcy are eli�iMe �o rtYCnc �hc
brnefii an1 w pnr'idr adJitio�ul idemii�'in� inWrtn:nwn �xtt.vrr ro allw' rounp� emrmmrnl �u bener mmitor Iamccm:d
filim�s.'11ii. inlormation w�ill M Ary4 con�idervial anA �n nnly h accesseJ Fr amhnriid canm�' olTicinls. lLe Ik�anmcm nf
Local Goremmem Finance ��ill u.e ihis iniurmatiun m arcam t«d. that will hcln munn� ufficiale diminaic M�menmd IrauJ.
Carl Albert / Karen E Fomey
529 S Race
Princeton IN 47670-2509
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Tuipaeeutiame Prnpertc Addresti
Forney. Cari Albert / Karen E
529 S Racc
1'rinceton IN;7670
State Parcel Number Leeal Description
26-12-07-403-003.410-028 019-03a10-00 SUMMERS ADD 31
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\ddrtss (Numbcr and svtt4 ci�}', sta�e, and'G[I' cak)
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ruriry� Numbcr (las� 5 digits) Driv s Liccnsc/Sta[c ID Numt
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undersiened certifies, undzr penalry of pepury•, that the above and foregoing infortnation is true and wrrec[ and that he or she is elieible to
�e lhe homestead standard deduclion on this property. Hach undersigned alio understands th2t, by claiming additional homestead deductions
rfully, he or she may be liable (or hack taxes and substantial financial penalties.
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� CLAIM FOR HOh1ESTEAU PRUPERTY TAX CHEUf� FOH YEAII 19_�i�_
, , SEF,� BAC�OR FILING IIJSfIlUCTIOfJS / /
I, (We) (J�/�x.�
March, 19 , I, (We) occupied as our principal plac°r�V
�hich a Hom stead Property Tax Credit is hereby beiha
u-
I, (We) owned
❑ are buying under contr
❑ have a beneficial inter � irr he taxpayer
Properly Description in Cou
Taxing District (Cily, Tow , Township): �
f
Parcel Number � or leya scri tion shown on lax state
I
._... __. .. _. . cr�ilily ih:it nn Ihr, ist d;ry cif
ence lhe lollowiny de;ciibed ieal pioperly lur
?d:
o�� '°3�r�'�
If buying on contract: Owners name °ee
Township
Contract. recorded in Recorders Olfice - Record No. _Page __
I( any portion of the residential structure or the land, not exceediny one (t) acre that inunediately surrounds that
sirucWre is used to produce income, describe the-use and portion ol lhe property utilized to produce incoine
Any other counties in which individual owns or is buying real properly:
I hereby certi(y the above statement is true, correct and complele
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County I o�a�nship
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IadigiCtY'ae eit � ow`1r s or is buying under a contract that provides hc is lo pay Ihe property taxes
������� residence, or has a beneticial inlerest in the taxpayer.
JU� 2 2 ���� - FOR ASSESSOR'S USE OtJLY -
0�-�� ��'-rs
- AUDITOR �
Land not exceeding 1(one) acre immediately .
surrounding residential improvements
Olher Land
Total Land
Residential hnprovements .pWelliny
Garaye
Total
Other Improvements
T� Improvements - Line (6) plus (7) equals (8)
I�eby certity the above is true, correct, and compiete.
S�g�ulure ol Assesso�
(�l
(2)
(3)
(41
�5�
(G)
(�1
l8)
True Cash
Value
(� �} ACTION E3Y AUDI1OIt -
1 G�,� y / r , 'L�- -
nnnrovetl:- ---.�..--- --------_..._
�sse�sed
Velualion
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Homestead
Valualion
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