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Prescribe0 By State BwrO af Tax tommissioners
CLAIM fOR HOMESTEAD PROPERTY TAX CHEDIT FOR YEAR 19��
SEE BACK FOR FILING INSTRUCTIONS
�(We) -'F' 0�-�-� ��� certify that on the 1st day of
arch, 19�Y, I, (We) occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) C�owned Qo�� I�wlBO
❑ are buying under contract Uw
❑ have a beneficial interest in the taxpayer . /�
Property Description in �-�-r+^� County "�`��¢ Township
Taxing District (City, Town, Township): �t' �a- �-tl
Parcel Number or legal description shown on tax statement:
- P� SCJ'��f /e -1 /L 3 5� 1d� /�.
If buying Ofl contract: Owners name ��� simoie ownerl
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: County Township
�hereby certify the above statement is true, correct and complete.
3
$l�M� MOR54
ana Zi0 �e
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
Land not exceeding t(one) acre immediately
surrounding residential improvements
Other Land � � � � �
Total Land
Residential Improvemen�s,
U�i g ��_
True Cash
Value
(�) .�iDo
(2) �S3 0
(sl 9a 3 0
Dwellin9 �4� �P �o
Garage
�j% � '�`�' Total
'/l � i /���•/tJ�
Other Improvements � ��
�
Tr�lmprovements - Line (6) plus (7) equals (8)
I.._.�by certify the above is true. correct. and complete.
�_. . i. Q �- . . . .
Signawre qi/lsussor
Approved
(5) �'
�s� I83�o
(7) 3ao
�s� l8 6 I o
- ACTION BY AUDITOR -
Assessed Homestead
Valuation Valuation
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Date: � /��
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
�laiE fOA\I!!!M IM_ f NMI
nfl0.tn'EI� BY [[V E IXNR� O! �M'I�l'nTZ. Tv
IAFASI:AERfORV�SIA
L�diviJual.. and ma:riN couple: arc Iimi�N to nric homc�ead uandaN cL^Aunion. A� �he �ecrip� of Nis dcdunion bccnmcs
more benencial, thrre is morc incenmr than e�er (or honxsrcaJ (rdud Ilomatead frdud cauxs hi�her Ia� billi tur all; theafore.
HEA 1373-?009 reqmrn uiparen �'ho rrmire Ihe hanestcaJ smndard Jntuction w.erify �fut th<. me dicidc �o recci.c tM1e
benefii aN to pnn�ide a�kliGOnal iJenoirine infwmar,un nemvey to allox' counn� ga'rmmrni ro bever muniror homrs�eaJ
fiiir�h. Iliis infamaiion will be Aery cmfileminl anA can only M aacrzud 6r autharieN conny� omoiais.'1'he Ikpanmem of
Local Gwemmem Fi�u�rc< ��ill ua [his inturtnation W crcate 0.wls tlui �vill h:lp aanev offirials eliminam h�mmsrcaJ iraud.
, • ' , . , .
•Taxoacer N•ame P � rt� AJd �
rioe � re» �� �
Barnes, Odean B& Martha O Gehl � /_
�i1
_ IF' I3 � 7 6—� -
h
I'rincc�on fN �7670 J
963
Odean B& Martha O Gehl Barnes
x
PrincetonlN 47670-8470
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State Parcel Number
26-11-10-300-000.080-027
V
Leaal Descriotion
006-00080�00 PT SW 10.2-11 3425 AC
D-17
1'
On�ner 1 First �/ AfidNc Lav
�j.v�,Q-�-v O �.e.a�,.� � a�rnen�
g Address (numbcr und �mx4 city, stsic, snd ZIP codc) - "' — -' " � Same as pmpem uddrev - '- -' '—' . . '--
3aq S 3�s� g �� �►� �. � c�
Social Securiiy Numbn (last 5 di¢iLS) Driver'
�
Spou;e Firsc Middlc Last
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Mailin¢ Addrati (�umber and sYrteL cii}', slate, and "LIP cotk) � S:une a� pmpmy mliUcv
3� Y.d . 3 z s W. P�,t�,� 6
Social Stturiry Number �last 5 digiu) Dmers License/State ID Niunber (la;t 5 digils) Ot er (plcue spec�fy in Part 4 belou�)
sae
. � � �
Each undetsigned certifies, under penalry o( pequry•, that the above and foregoing infonnation is wz and correct and that he or she is elieible to
receive the homeslead standard deduclion on this property. Each undersiened al>o understands �hat, by claiming additional homestead deductions
unlau�fully, he o; she may be liable (or back taxes and substannal financial penalties.
Owncr I Signawrc Date Tciephonc (
V c�-an.� � 0.rvn.e�Z �
Spou±c Sitnawrc pzi� Tcicphonc
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11 1 �' 1
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