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� e%' "n � CLAIM FOR HOMESTEAD PROPERTY TAX
� ia�.= CREDIT/STANDARD DEDUCTION
,�yp .;;�� State Form Sa73 (R2 / 5-92)
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INSTRUCTIONS: See reverse side for liling instructions. �
FORM - YEAR_
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��We) _�!;���w —��042.�—.�c� �,� ,�.a�any�ente�cne lst day of Mamh. 19�
�) occupied as our princip I pla �,� ence i e followm scribed rea� property for which �j�t��Prpqq� Tax Credit is hereby c�aimed:
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�(We� owned Are buying under contract .
❑ Have a beneficial interest in ihe eniiry that is liable for the property taxes on the property aryQJhat owns t� pr�r��� buying under a contract.
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cOntraCt
iRECORDED
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PROPERTY DESCHIPTION
County � . • Township � . Taxing tlisirici (c��f/y/,.ipwn, fownship) . .
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Parcel numDer Legal descnptio�3 3, 30
pOC - O/f.2.f YE .J(,t� - /,Z S
It any portion of the residential structure or ihe Wntl not exceeding one (7) aae that immetliatety surmunds Mat struciure is used ro produce Income, describe Ne use arW portion
of ihe property utilized to produce income.
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PROPERTY OWNED BY CLAIMANT IN OTMER COUNTIES
Township County
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' � Signamre oi claim
�zby certdy the above statements are irue, correct and comp ete.
Addre;s�mbera sneet.ci�stat�ZlPcode)n�
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ASSESSOR USE ONLY � TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VALUE
land not exceeding 7(one) acre immediately
surrounding residential impmvementa (�� �
Otherland (p)
Total land (line 1 plus line Z� (g)
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 ihe abOVe is [rue. Corretl, and Sgnamre of Assesmr Date signed
complete.
-��=.i ing action - Sgnature of Audi;or Date signed
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19_Pay19_
Lesser ot 1/2 Homestead
Valuation or 52.000
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SignaNre o( Auditor Date signed
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
SIAiElORM ��M IR`/ uM1 1RfAS11AfR Po0.V 11A
h�diviJuaL. and ma:ried aouplr.. are limi�ed io ore hnmcweaJ �andaN Jnlu.�ion. As the rccript of this dadunian hcrnies
murc beneficial, there i> morc i�rcrntive dun ecer (or homesttml GauJ. IlomesxaJ Baud cauxs higher ia� bills (or all: thefefae.
HEA I;li-?0(19 requvn uapa.en who receive thc IwmesteaJ s�andard JNuction m verify that they are eligiNe �o rcni.c �M1c
benefit aN m pnn'ide adeliiional identiiyim_ infurm:nwn neasvrv ro allw' cwnp' na'rmment ro Y.Imr moniror homrseaJ
filin�. ffiis infnmulion will M Ae�v contideNial anJ r�n only M aaccrosed by aullnri�eA rnunh' oTiaiuL�. The Ikrynnxn� of
Lueal Gmcmm<m Finam�e xill mc this inturmafion N crwte twLr tlut �rill h;lp coimtt� uhfxials dfminnrc 1roma�cad Baod.
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� Taipaver Name PLUnertt�Add
Abu Hussein, Saleh A
% R3 I3ox ?SR
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\ ��� Princeton 1\ i7670'
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Saleh A Abu Hussien
R3 Box 288
PRINCETON IN 47670-8421
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State Parcel Number
2G03-35-300-001.525-027
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Lesal Description
006-07525-00 PT SW 35 1 12 3.308 AC
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Owner I First Middle i L.ast
S�C�1� �i /�bu f-luss���
�e`AGdr�s lnurtibcr and sucM, ciry,�swm, andZiP codc) '— -- -' -- — --- � Samc ns pmpcm� rc3d-� '—
'a ya cv � s�fP s�� �-,�� �to �'' 6 ��
$ocial $murih'
Spou;c First Middlc Last
Mailine Address (NUmber and �Yrcq c��}', stale, und "LIP cude) � Sume as pmprny addrts;
Social Sccurity Numbcr (lazc 5 digi�s) Drivcrs Liccnsr/Statc ID Niunbcr (la;t 5 dieits) O�hcr (plwc spcciN in Pan 4 bclow)
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Each undersi�med certifies, under penalty of peryury•. [hat the above and foregoing information is trve and correct and that he or she is eligible to
recei��e the homestead standard deduction on this propeny. Fach undersigned also unders�ands that, by claiming additional homestead deductions
unlawfully, he or she may ix liable (or back taxes and substantial financial penalties.
Owncr 1 $i � Uam Tclephonc
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Spousc Si�mamre py�e Telcphone
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