Homestead_Beasley (3)Gibson County Audibr
101 N Main
PRINCETON IN 47670
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STATEi[I[M!lW IIL'/�NI
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InJieiJuaL. anJ �rtxriN coupk� are IimimJ m nnc home.�eaJ MandaN J:ducuon. As Ne uceipt ol Nis dcduainn Mconrcs
more benencial, thrr< u mwr incrnme Ihan e�er (or homottsl inud. Ilome�ead fmwl causes higher tac 6illi fur all: thrrt(ore.
HEA liii-?IXM) «quim mxparm who reccire Ihe hanes�caJ sundvd JNuction m veriiy dui they am elieiMe io meene the
benefit aN to pnn�idc akli�ional idemiiyfrc� inWrmavun mee.san� io allw� vounn� ro:rmmem ro bater monitor humesteaJ
n��. rn�� ��r��,,,���� ..;n n.� Gqv �r;�!m„i �ml can only M arce: uv1 by authorimd rnunty n(Ticia6.'ITe IXpannrni nf
Local Gm'cmmem Fimircc oill uw this intormazion W cream 4ds �hat will help cpmtv of(icials elimin,ve homcstead fnud.
. � � � �
T•rtpaver Neme Propert�• AddreSs
� R , yo� >p,
' Princeton IN 57670
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Same ati pmprm addresn
4 bclow )
undersiEmed certifies, under penalry of perjury•, that the above and fure�oing infortnation is We and correct and that he or she is eliefble to
�e the homestead standard deduction on this property. Each undersi¢ned al>o understands that, by claiming additional homestead deductions
rfully, he or she may be liable !or back taxes and substantial financial penalties.
CLAIAA FOR HOAAESTEAD PROPERTY TN(
CREDIT/STANDARD DEDUCTION
State Fortn 5r73 (R6 / s-03)
Prrov(bed Dy tlfe DepaNnmt d Loral Ga+anmetM F'ma�xe
INSTRUCTIONS: See iewras s/d� b fBrp ietbu�ortt.
� �e� '
I(We) occupied
, Have a benefidal interest in ihe enfity that is liable for the pmperty taxes on ihe property and that �
II buying om m�irad, Fee Simple ownefs name
Recarders ofice where mntraa is
County Tamship
Pa cel nu 6er l de:
- 0-E,b
i( any porlion o/ iha resitlan�lal sW cNre w the land nd
�wa�o��,��������.
�o��,Y
To.vnship
Tating district (city, tawn, townshiP)
FORM 1 ' YEAR
HC10
t�aw/�n��.t�p� e 1st day of March, 20_
P�o�EityT�c Credit is hereby daimed:
is buying under a conVaU.
Record number
Pa9e
J ������ I Is the Oroperty in question:
❑ Real propeM ❑ Mobile Homo (I.C. 6/.1-7)
one (1) aae that i meEiatery wrrounAS that swcture is used to produce income, descnbe �ha use an0 portbn
• ��a��.
I hereby certi(y the above statements are We, corred and complete.
(number aM SVeef, city, state, ZlP code)
Land not exceeding 7(one) acre immediatety
surtounding residendal improvemenis.
Other land
Total land (line 1 plus line 2)
Dwelling
�Residentiel improvements w MnuaOy
� ��� / �� H� Garage
Other impravements
TUaI improvements (line 4 fhrough line 6)
TUaI value (Gne 3 pOs line �
I hereby certify the above is W e, mrred, and
complete.
Veritying aclion - SignaWre oflwditor
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l2)
(3)
(4)
(5)
(6)
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IB)
Sianature ofAssessor
County
signe0
Date signed