Homestead_Might�� ., ..
���°. CLAIM fOR HOMESTEAD PROPERTY TAX
i���� CREDIT/STANDARD DEDUCTION
�;, Sta;e Form Sa73 (R2 / S92) .
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INSTRUCTIONS: See reveise side 7oi liling instructions.
STATEMENT
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I(We) L��.�1��✓ 0%�n�—�--� - certify�y���tlTiS h ch, 79�
I(We) occupied as our principal place of residence ihe (ollowing desc ed reat propeny for which a Homestead Propert i ereby Gaimed:
(We) owned ❑ Are buying under contraci . . .
lave a beneficial inierest in the emiry ihai is liable for the property taxes on the property and that owns the property or is buying under a contrect.
� � � - CONTRACTRECORDED � �
If buying on comraa, Fee Simple owner's name , , .
Recorder's oHice where contrect is recortletl RecoN number Page
County
Parcel num6er I Lega descrip��
nl9-c�(ga'f-a�
If any portion of ihe residential strucwre or ihe land noi ezceeding one (7) aae tha
ot Ne property utilized to produce income.
toNO,
that siructure b�used ij produce incdme, d95cribe Ne use antl
PROPERTY OWNED BY CIAIMAM IN OTHER COUNTIES
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I hereby certify the above statemenis are true, wrrect and complete.
(number antl streeL ciry,
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON•RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvements. ��)
Otherland (p)
Tmal land Qine 7 pWs line 2� (3)
Dwelling (4)
Residential improvemenis .
Garage (5)
Other improvements (6)
Total improvements (line 4 through lina � (7)
Total value (line 3 p�s line � (g)
I hereby Certify the above i5 irue. CorreCi. and Signature ot Assessor Date signed
complete.
Venfying aaion - Signature of Autlimr Dare signed
STANDARD
79_Pay79_
Lesser of 7/2 Homestead
valuation or 52,000
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Synature ol Audi,or' �_ �\ .,/�/' n, w I ua;e �q,=in -
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
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.1�IR(T'Ef�BI'ci�1l.Bni0.1)OINYYII.\lt`u� PI.F�lAlI1InBYi11[OVMI\4vllilflClCA\cRYMlA'IiP:n\CEI('0.1.1-L`-�.1
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InJiviJuaL aoJ mv�iN coupl� are limi�ed �o oce IromeyeaJ vamLtnl Jalu.�ion. As ihe recerpi ol �his Jcdunan Mconren
mure beneficial, thrrc i+ more i�rcrnmr than ner (or homnrcaJ frauA. Ilome��ead fraud cause� hi�hrr tac bill> for all; the¢fa<.
HEA I:+3-30(19 requim uapasen who rtceire thc hanes�caJ s�andard �vluction w.eril'y iha� �he�� are eligiWe io mcei�e ihe
brnefi� am1 to pnxide a�Llitiunal identiiyimt infumcitwn necosarr to aliw� vounry� gmrmmem ro Mtter mmitw Mmesead
�ilin��.'17iic infmmalinn will M AryV cnn�idenlial anA rdn nNy h actttmi hr authnrivcJ mwny Mlfcial�.'I'hc Ikpanmm�t nf
Local Gwertvnem PinaMC will mc this informanon ro crea[c [ouls �hat aill help a�mn� ofiiciaLs diminme hom<straJ Baud.
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Tazpa�•er leme Prnoertv Address
Might, Lawrence / Thelma C
ieis ni,ari
� Princeton IN;7670
° — 3930 - - - - - -- - --
Lawrence / Thetma �G��
C/O Thelma Com
1615 Blvd PL
Princeton IN 47670
State Parcel Number Leeal Description
26-12-18-302-001.824-028 019-01824-00 BROADLEIGH PARK 127
PTl71 PT/72
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Oaner I ./�'l First Middle �\�� Last
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' '- �g Addr6s (number mid stsct, <irv, sure, and ZIP code) --/ — - � �-- - - . . j� .Snme ¢s propem oddiev — - —� - --
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� �c3 �'� • Y�� . �i,!�aiu'.��// � /`76 �j O
$ocial Scturil} Numba (last 5 dieib) Uriver's Liccnx/$iatc ID Nmnbcr (lui 5 digits) Other (pleut specify in Part 4 p�low)
Spou;c �7iLlL�✓ First Middle Lact
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Mailine Address (�umber and svee4 �q'. sia�e, and "LIP code) � S;une x� propeny addres;
Social Sccuriry Numbcr Qaz� 5 digi[+) Drivds Liccnsc/Statc ID Nwnber (last 5 digi�s) O�hcr (plcasc spcciN in Part 4 bclow)
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Each undersiened certifies, under penalty of perjury, that the atwve and foregoing infonnation is we and cortect and that he or she is eligible ro
receive the homes�ead standard deduction on this propeny. Each undersigned ai>o unders�ands that, by claiming additional homestead deductions
unlawfully, he or she may 6e liable for 6ack taxes and substantial financial penalties.
U.'ncr I Signauue Uate Tdcphone
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Spousc5i�namre � p,�� icicphonc
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