Homestead_Beard (3)�res;cribed By State Board of Tax Conmissioners
CLAI��1 FOR H((�'�STEAD PROPERIY TAX CRQIIT FOR YEAR 19� �
SEE BACK FOR FILING INSTRUCTIONS
I �e) ��,n .JJ� -�.r���2����aR ���o m,., 1��� oertify that on the lst day of
,+_�:, 19' , Z, (i9e) occ�ied as our princioal olace of residence the follaaing describcd real
nrooerty for which a Homestead Property Tax Credit is hesPby being claured:
I, (T•'e) � v�msi
� are buyina under oontract
� have a beneficial interest in the t.axpayes
Pmtprty Description in �L, �
Taxing District (City, Ta•m, 7bwnship) : �2
DO6 -DO�a�.�o
County . �� 2bwnship
, i �
�arcel ihmiber or legal description shown on tax stata�nt:
I,� �/c� � ��' v /.5-�-�� 7..So��
I= buvina on �ntract: Owners name (fee simple owner)
Contract recorded in RP�rcier's Office - Recard No. Page
If any portion of the residential structure or the land, not e�eeding one (1) acre that
im�iiately surro�is that structure is used tn pioduce incane, describe the use arzl portion of
�° ProPertY utilized to produce ir�ome
Pnv other counties i.n which individual v�ans or is buying real property: '" Coimtv 'Ibwnshio
e
certify the above statarent is true, oorrect arxi cong�lete.
*individual eitJ�er aans or is tuying tmer a oontract that provides he is to pay the
pr-operty taxes on the residence, or has a beneficial interest in the taxnayer.
- FQR ASSESSOR�S USE ONLY -
iarri not exoeeding 1(one) acre irtrtnediately
surroun3ing residential i�ivvv��-nts
• - . ..
Total Land
?esidential 7npmv�rn-nts
Raelling
�Garaae
�c �'��`� �Total?27o
Go%- J483- sSS�o
'IYue Cash
Value
(1) .� ,ni:
t2) / � �i' n
(3) l 7 R r7
(4) ,�77 ;D
cs> �fl
(6) ."'�. F.
Assessed
Valuation
/ 7fi
`��/O
Hanestead
Valuation
otner I�rovanents (7)
?7�'�� �n
�� Impn�v�ients - Line ( 6 ) plus ( 7 ) equals ( 8 ) ( 8 ) ,�rr---��
:eby certify the above is true, corxect, anl axrmlete.
i�t.e
- ACTION BY pUDIT�R -
4.c�r�va3: Date:
�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
3526
Richard Lee / Velma Beard
2728 E SR 64
Princeton IN 47670
nrwsu�rnwxv:su
InJividuaL. and ma:ricd coupl� are limi�ed to onc homesieaJ �andaN A,�lunim. As �he receipt ol' Nis dMunion Mconm,
morc beneficfal, thrre i> mo�e ifrcrncn'e ;han n<r for M1ome.ieacl (raud Homd'rcsl f`aud caus� hi�her �a� bills (or all: therefore.
NEA 13i3-?IX!9 requim �ixpa.en ..ho receire the hanmead simdard JeJunion m veri(y �ha� �hey are eliciNc to marne thc
brnefii aN ro p�m�ide H(IJhIUNI iJrntiirinc inWmcmun �RCr.'vn� to allw� tounn� gm'emment �o bnter mmitw Iwmes:e:wl
filit�,�.'ITis inlomulim wiil 6e Aryv confidenlial anA rdn nnly h- acre:.�vl Ay aullm�i�M oowh' o(Ttiuls. lTe Ikrytnntenl o(
I_ucal Gwcmmrn� FinaMC ��ill uc thfs fnformation tu «ca:c twls Uut �vill h:lp cwnn� ot%rials dimiwm IpmcstraA fiaud.
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Taspaeer Name
Beard, Richard Lee / Velma Pauline
State Parcel Number
26-12-15400-000.127-027
V
Prnpert�� AJdretis
?I3o�IW�
Princeton I\ ;7670
Leeal Description
006-00127-00 PT SW SE 15 2 10 15.00 AC
D-10
1' 1
Ox�ner I First MiJdle Lazl
� �: L'� O[Sl� rd
ngAddrtss(numberand->t¢ct,ci�y.state,andZlP<ode) —.—..— --' - Samenspmpemodd� �- —' --
..❑' •__
7a$ �►�sf st�iE ,�o ,� 2r�c�%o;� � �f7G7c�
$ocial Stturity Number (last 5 dieiLS) Dmers Licensd$la¢ IU Number Qul 5 digits) Other (pleasc sp¢if,v in Pan 4 bclow)
Y
Middlc Last
q /����
(/ � /9 U � 1 VI E � �11^ �
Mailing Address (Number and slrce4 cii)', siale, nnd ZII' cu�k) � Same u pmpeny add�s
%.'2U E / 7l%i�L Ov4d �y �vl[c` /dt1 G i�i
Social Stturity Numbcr (IaA 5 digiLC) DrivcYS Liccnsc/Statc ID Nmnber (lazt 5 digits) O[hcr (plcasc spcci� in Part C bclow•)
x
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Each undersi�med cenifies, under penalty of pepury•, that the abo��e and foregoing infortnatiun is we and correct and that he or she is eligible to
receive the homeslead 5tandard deduction on this property. Each undersi¢ned al>o undersmnds that, by claiming additional homestead deductions
unlaw�fully, he or she may be liable for 6ack taxes and substantial financial penalties.
Owocr 1$i turc Uate Tci<phonc /
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