Homestead_GladishweM nc io iem
ReuriDed By S�ate BwrO ol Tae Commissioners
CLAIM FOR HOMESTEAO PROPERTY TAX CREDIT FOR YEAR 19�
To & Filed in DuDliwte
✓
SEE BACK FOR FILING INSTRUCTIONS O((l � �QQS�, ��
�� ,
(We) ��"' � " �ertify that on the 1st day of
March, 192�, I(We) occupied:as our principal place o residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
O are buying under contract
O have a beneficial in�st in t�he t�yer
P.roperty Description in
Taxing District (City, Town, Township):
Parcel Number
If buying O(1 contract: Owners name ��� s""oie ow�er)
���-�"� Township
or legal description shown on tax statement:
�C �-� Q,�.�_ � 9
- 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:
�hereby certify the above statement is true, correct and complete.
County Township
' indiwduai eitner owns or is ouying unaer a contract tna[ prowaes ne is co pay cne propeny 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 � �p � �"1 �
Total Land �, �j
Residential Improvements
JUN ? =� i979
d
Dwelling
Garage
� �/���� Total
Other Improvements � AUDITOR
T�mprovements - Line (6) plus (7) equals (8)
I y certify the abq'G� is true. corr¢Ft. and complete.
SignaWre ol Assesmr
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RaIEfOR.\1!�Yw11L'/�wl 1➢Fi�$I:RIAf00.Vil1A
n�YRm'EI�BY�l�IEYMRU(N.MOI.'�Ta.!nr1 PIIE4A�BmBYi�I[UE�MTNFY�OFLG:ALGO�'eLYNfI.'lfY:n.�fE1C�1.1�Li1
Cibson County Auditor
101 NMain ' �' � � 1 . 1 ' • �' • • •
PRINCETON IN 47670 IndividuaLs anJ ma;riN mupks are limi�ed to ore hortreMead �tnndaN dedu.iion. A> ihe rttcip� of �his dNuction beconxs
� morc bemncial, therc is more fncencne than e�er (cr homntead fr�ud. Ilomes�ead fraud caaca hichrr tac bills (or all: thnefaz.
HEA 13�1-i-]/1�9 rtyuim uxpapm who rmirc �he hwnestc�J sundard JNuctmn m�rorilv that they are eliciMe m mcen. �hz
benefit aN ro p�m�ide akfitiunal idrnnipm_ in(wma�wn rccecpn� ro allw� oounn� em'emmmt ro b;nzr mmiror homesrcad
filinF�. This in(orrtulion will 6e {,cp1 mn�idenlinl mA can nnly 6c acrez¢d by authnrixed rnwq� oflicials.'fhe Ikpanmcni nf
Lucal Gmcmmrn� Pi�uM'e wdl um �his in:ormation w crcam uwls that �cill h:lp �ant}' officials climmarc hwncsicad fiaud.
1163
Taxoacrr Neme Pronrrt�' Address
Gladish, Roger D/ Donella J
6?i S Stout ST
Nrinceton IN 47670
Roger D/ Donella J Gladish
625 S Stout St State Parcel NumAer Leeal Description
Princeton IN 47670.2533
�i�n��ni�i��u�u����inn�i�i�i�n���iu��ni���i�i�n��nl 26-12-07-404-000.959-028 01�00959-OOKOLBSADD29
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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.
I First Middle
� 1�� _l�+ ��7� �i.]`l� �
� Address (number wd �aeet, ciry, stare, and ZIP code) � Sume as pmperty oddr¢;
2�5 �. S v-�-- S Pr � ce�' �. 7�-�
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Address (t:umbcr and svcc4 ciiy, sw�c, and LIP cak)
�....__._I �( � �, s'
� S:unc u pmpeny addres
Otha (plcau spccify in Pan 4 bclow)
undersicned certifies, under penalry of perjury, ihat the abo��e and foregoing infoRnation is trve and correct and that he or she is elieible to
;e the homestead standard deduciion on ihis property. Each undersi¢ned al;o understands that, by claiming additional homestead deductions
��fully, he or she may be liable for back taxes and substantial financial penalties.
I Sicnawr< lhv-
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