Homestead_FoxCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
sreee F«m s�n (RS / a-aiI
ReaalDeE M the Depaitr�rom of Locel Cwvemrnent Finarroe
INSTRUC710NS: See iatr.ZS aid� b�p'sw6u76ony
�� FORM YEAR
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��e) c���-zu ��-i �� ceRify Ihat.on lhe 1st day of March, 20_
T�/ -,_ !f � -.:
I(We) occupied as ou principal place of sidence the following escnbed real property for which a Homestead Pmperty-T�Credit i�hereby daimed:
�(We) owned ❑ Ne buying under wntract GIBSON COUNTY AUDIiOR
, Have a benefidal interest in Ne entiry that is liable for the property taxes on the property and that owns the property or is buying under a wntract.
If buying on conVad, Fee Simple ownefs name
Recorders af6ce where conUap is recorded
Counry � Tamship
Parcel nnumber c Legal "pNon
�"1 r V
H any ponian of Ne resiEenllal strucNre or Ne land na ezceeding one (1) aae
ot thepro� �aduce income.
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County
Tarnship
I hereby certify fhe above statements are We, corred and compiete.
idreu (num6er ard sbeef, dty, sfafe, ZlPCOde)
��_'7 �2 'r 1 i I f r �� I
County
Record numher � Page
(ciry, roym.
Is (he pmperty in question:
/L rnrn ''
� � D�operry ❑ Mobiie Homo (I.C. &1.1-�
iunds that structure is used to produce inmme, desttibe Ihe use and portion
'i- „"�' � '�c.t,�'"s3:'�.- �j,�i ��
�'� F� ''� � � � =�'TRUETAXr��- ASSESSED VALUE ' HOMESTEAD `" NON RESIOENTIAL ��°+
��` ASSESSOR�IISEONLY� »� �
�;,,�h���;uqc ���,�„�4'�i��T'�� �xVF1l:UE;,'=��.�� �"�ATa100%�OFjTN� �-��^-,� VALUE�,s� ���.'� �; VALUE=�'��y4�
La�f2-�.� .. .-f�
Land nol exceeding 1(one) aue immediatety � ��- s`,n,�%r�'°` s,.'�.x,��y -��,Y;
surrounding residential improvemenis. (�� ,a.,���yN`� �;_ ����� Y
Other land / '�s<� �����pi`
`Z� 3£ 3�?.�i ��{ttilS
�Y!fl
Tdal land (line 1 plus Irne 2) �3�
��°- r. r•.•� e.r � .�
Dwelling (4) -��"` Xa��� a�'�,r��
�Residential Improvements wMnueOy ��`��' � l` � t
„-,�a�cs -<
Mse�ed Mobib / Manufadured Home Garage (5) :'z ,` ,�;
�L � ��'Y i � �
;T"•#"q.^�' <'6�``.i
Other improvements 5 �;� 3�-'� ti��
( ) ; � �,'.;ra--�
.,�_.3 .rf".:s:�a�'�
Tdal improvemenls (line 4 through line 6) (�)
7Ual value (line 3 phs line n (g)
I hereby certify �he above is We, corted, and Signature otnssessor �a�e signed
complele.
Vei(yug aclion - SignaNre oflwditor �ate signed
20_Pay20_
Lesser ot t/2 Homestead
vuuauon a f35.000
SgnaLUe or Auditor
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Gibson County Auditor
101 N. Main She2i
Princeton, IN 47670
.�.vt may �:sw�av.in�
nrrcm'¢n xr �ve 3n�xr.i
,�..s��«��i,.,
Indi.'iJual. anJ marrfeJ muplo a�e limi�nl to nnc honxst�d sunSud Jrductiun. �b ihe reveipt of :hi� deAuoiun hecomn
.moru Ircnc6cial. IFk c fs morc inccnti�c �Iwn cccr lor hoim:stc�d Gaud ilomnicad fmud can�cs nichcr m� bill: lar aIC �hcrc(on.
YG} Ilii.\ 13�9-?1X19 reyuih uxpa�rn who rccirc :hr homc>itad sundarJ deJuctian Io rtrify ihat �hey art elieihle to rnti�e�the
Ixnefi� anJ m prmide aidiiio:ul idrmifying ir.�nrmanon neces<an� io nik.a enumr gm'emmem �o b.ucr monimr honx�cad
.� ', • filir.c. Thi in(arnu�im xill be Acq confidential and can nnk be snr..rJ'Irv amhuriud coumr o0icials. lhc Depmmen of
Loaal Gmcrmcm �wn�c will u.t �hi, infortna�ion �dcr.aic troR ,hat w911 hcip counrv officul.. climin�i.• Mmc.�cad inud.
� � � . � . � . . � . � , �
. � TaxpayerName LocationAddress
T Fox, Benjamin J/ Deanna M. r- •
� O� I� 2��2 623 E WATER ST
C.�.��" � PRINCETONM47670 � �
919' ' V v '
GIBSON COUNTY AUDITOR II I III��III �IIII �IIIII� II �n II II�InI �II�II�II�III�I I I III I� II II�I�II I� II
Benjamin J Fox - __
623 E Water St
PRINCETON IN 47670-2241 . � ',
'lll�'��"I�'���'I��"III"�I'�'��I���'I�'���"'IIIIIIII'�I�II'��I �-� State Parcel Number � Leqal Descriotion �
" "�� 26-12-07-402-000.875-028 STORMONT ADD 19 PT/23 PT p
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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.
� F�rs�
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�4M . �
umber and svcci ciiy, sta:c, and "LIP codeJ�
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Fnch undersiened cenifies. under penalty of pequry, that the above and foregoing information is cme and correct and �hat he or she is eligible to
receive �he homestead standard deduction on this property. Each undersignal also understands that, by claimine addi�ional homest�d deductions
. unlawfully, he or she may be liable for bacA taaees and substantial financial penalties.
Ow'n r I$ig�tum _ Dam �.
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o .i " ure Da . Tclephone . . _ . .
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