Homestead_BartleydEe '��°a CLAIM FOR HOMESTEAD PROPERTY TAX
}��� CREDIT/STANDARD DEDUCTION
�;,'� State Form Sa73 (R2 / 5-92)
u,•
INSTRUCTIONS: See reverse side !or /iling insfructions.
- � .. _ � � ' - � � . °-CERTIFICATI
� � �. �. �.� �
' F� 1 19 YEAR
HC70
-!� .
l?° ;,��.; �Oi;F.n� !,l�qlTOR .
NT_� � .... _ � .
I(We) ���_ '� certify that on the tst day of March, 79
�� occupied as our princip place of reside e the following described real pro y for which a Homestead Property Tax Credii is hereby claimed:
I �We) owned ❑ Are buying under contract _, .
� Have a beneficial interesi in ihe eniiry that is liable for the pmperty taxes on the property and that owns the property or is buying under a contract.
- - - � CONTRACTRECORDED � �� . � �
Ii Wying on contract, Fee Simple owner's name+
Recorder's oNice where contract is recortled Record number Page
PROPERTY DESCRIPTION
Counry - . Township . T'ng dis rict (ci town, iownship)� �
Parcel num6er I Legal tlescription
� �l�
I( any portion of the residential slmcWre or the land not exceeding one (7) acre that immediately surrounds ihat structure is used ro produce income, descnbe the use antl portion
ot ihe properry utitized ro produce income. .
County
-- PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Township Counry
certify the above statemenis are irue, correci and complete.
;nu�mberands�et.city.stafe.Z/PCode) �
� ASSESSOR USE ONLY
Land not exceeding 7(one) acre immediately
surrounding residential improvements.
Otherland
Total land (line 1 plus line 2�
Dwelling
Residential improvements
Garage
Other improvements
Total improvements (line 4 through lina �
Total value (line 3 p�s line �
I hereby certify the above is true, correct. and
camplete.
Veriying action - SignaNre of Auditor
19_Pay19_
Lesser of 1/2 Homestead
Valuation or 52,000
TRUETAX I ASSESSED
VALUE VALUE
(�)
(2)
(3)
l4)
(5)
(6)
(�)
le1
Signature ot Assessor
STANDARD
S
HOMESTEAD
VALUE
Township
NON-RESIDENTIAL
VALUE
Date signetl
Date signed
W
Gibson County Auditor
101 N. Main Street
Princeton, IN 47670
�� �ILED
MAY 10 2012
— G'J. m �-y
v �,
— GIBSON COUNTY AUDITOR
3478
A.1tI fU2N33W�P�I4o�
.\VPRN cP 91' TU' M�RpOf 3rttnii Y.a
IR:TSORkRlOqAlS:A
Indiciduab and rtnrricJ couplr. arr IimiteJ m one honw tnJ .tanUrd JNucliun. :b tY.r rtteipt nf :hi� JNuctiun henma�
more beneficul. ihtte is more ir.crn�i�c Ihm cvcr Inr honr::tead l�uJ. clomc�,nd frauJ cau�c� hieFcr tas bill. I'or �Ih th �ctore,
IIF:A 13J9-?009 rcyuir.�s taapa.'m wSo rtYCi�e :he homr�tcad >ianJarJ deduction to ceri(y �Fa[ diey arc eligihle ro rtttive �ht
bcncfi� aml m p�midc aWf�ioaal idcmifi�ing irliuma�ion ni:caan� �o alL.w coumr em'cmmcm ;o �ii�cr mimiior homc� yd
filinu. Ihu infornu�im will br krp cmfid�minl end can onk M1e a�zr,uyl b.� authwienl counry� nllicul.. The Dep�rm+en of
Liral Go�'cmr.km h5�uncc ��iil u.c Ihi. inlorma�ion �n crun�c �n�R thal uill hclp counrv officials dfmirt�ic Mmcucad Iraud.
. � � � �
- Taxpaver Name Lowtion Address
Bartley, Virgil R/ Shirley A
Virgil R/ Shirley A Bartley
808 S Deer Haven
PrincetonlN 47670-8854
I���I���'���II�II����I'�"II�'I'�"�II�I�'�I'I�I"'ll�'�'��I�'I�I
808 S DEER HAVEN DR
PRINCETON IN 47670
II�I�III��III ull I III ull I�I�III IuIIWII��II�II�III �II�IW II IIII II II�I�I� II (I
State Parcel Number Leqal Description
26-12-15-100-001.773-027 PT NW 75 2 10 2 AC C-1
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.
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Each undersiened certifies, under penalty of perjurv, that the above and foregoing informetion is we and correct and that he or she is eligible to
rcccivc the homestead s[andanl deduction on this property. Each undersienecl also underslands that, by claimine additional homestrad deductions
unlaa•(ully, he or she may be tia6le (or bach taxes and subs�antial fir.ancial penalties.
(h�'ne� I $i�^nxture Dare