Homestead_Andis�,. .,.,,
y t CLAIM FOR HOMESTEAD PROPERTY TAX
i� CREDIT/STANDARD DEDUCTION
+ State Form 5a73 �R2 / S92)
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INSTRUCTIONS: See reverse side /or liling instructions.
. . _ ., - � . . .-, -• .- . .. - - --��:rcrmc�csn
FORM YEAR
HC10
(=i %� �' e �'- . ,
1(We) V L���- certity that on the 1t st day of �March, 79_
I(We) occupied as our ri cipai place of residence the foliowing described real property for which a Homestea� �peiryJa�ae�it is hereby daimed:
,r' I(We) owned ❑ Are buying under contraci /` � � �� ��
Have a beneficial interesi in the entiry ihat is liable for the property taxes on ihe property and thai owns,ihe�roperty or.is tiuying�under a contract.
�cro�:. • �t�,n,'�C.l .
-' -� - - _ �CONTRACTRECORDED . � ' - - -�
If brying on contract, Fee Simple owner's name
Recorder's oflice where contract is reCOrded Retord number Page
. . - � . � PROPERTY DESCRIPTI . . � . � .. � • ' - . .
Counry { Township Tasing i'(', t /nJshrp)
1` �'"
Par�t}(nqer 0/��� � Legalde5cnp�ion / �` � / / A �_/� '� � ��
viv T �� j'�/ �j�
It any portion of Ne res"Wential svuc[ure or [he land noi exceeding one (1 � aae that immediately surrounds ihat structure is usetl to produce income, describe the use and portion
of Ne pwpeM utilized ro praduce income.
��� ASSESSOR USE ONLY ' �, TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL`:�-
., - � VALUE VALUE VALUE VALUE -�� �
Land not exceeding 1(one) acre immediately - , � . -
surrounding resideniial improvements. (�) � ?° � -
Otherland (p) �
Total land (line 1 plus line 2� (3)
Dwelling (a) . �
Residential improvements - .
Garage (5j � �
Other improvements (6) �
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line 7) (g)
I hereby certify ihe above is true, CorreCi, and Sgnamre of Assessor Dare signed
complete.
Verityirg attion - SgnaWre of Auditor Date signed
•
Gibson County Auditor
101 N. Main SVeel �
Princetan,IN 47670
e
FII,ED
APR 7 20�{
APPFDJEDBI'
� i=.J�TS.
TNFwSURpliOiNiS1I
R FlN�1 VY'E IC 61 J-112.1
Individuals and married roupla are limired'ro one homcaead ztandard deduniou. As the receipt of dtis dnluctian hecomes
morc brneficial, �Lerc is morc inttn�rc ihan n•er (or homestead faud. Homestead fmud causes higher ux bills (or all; thertforc,
HEA 134i-?009 rtquires �azpa}rrs aiw rceen< the homesiead standard deducuon w�crify that they art eligible ro recei�c the
bcnefii and to proride additimul idcniifi�ing in(omation ncccssazy W nllow couvry gwcmmrnl lo.beuer monitor homes�ead
filings. Tlus infortnation uill be kept confidrneial and can onty be accesscd W authorved caumy ofiicials. The Departrnrnt of
I.oral Goremmrnt Fin.ntt will use Ihis infomurion ro create lools that will help counrv ot5cials elimiriate homestead Raud. �
•� �' 1
Taxpaver Name� Location Address -�
Andis, Danny R/ Tina E � �
C'J. �.�
1348 tt „,•V�:
GIBSON COUNTY AUDITOR
Danny R/ Tina E Andis
605 McCarty Road
Princeton IN 47670-2856
'I�I�I��I'll�"�I�"'��"�"���I��'���II�'ll�l�l��'�"III�I�'I"'
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605 McCARN RD �
PRINCETON IN 47670
I �III �II I��IIII�III �I �II�II�III QII�I�III�II01
State Parcel Number Leqal:Descrintion
26-12-18-301-001.422-027�PTSW 18210 1.57AC
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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.
Addrtss (nvmh4 a� stcect, city, statc, and ZIP codc)
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«uriry \�unber (lazt 3 digiG) .Drivcfs Licensd!
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iu ID Nimmber
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Samc az property eddress
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undeaigned certifies, under penalty of perjury, tha[ the above and foregoing informa[ion is we and correct and that he or she is eligible ro
✓e the homestead standard deducrion on this property. Each undersigned also undersiands that, by claiming additional homestead deducrions
✓fully, he or she be liable for back ta�ces and substantial financial penalties. � - .
� I Sign�a / Dau Telephwe . . �
7'' / . � �- !l_/ _ii �