Homestead_Bosswan� nc ia ism
PrescriDeE By Sta�e BwrO ot Tax Commissioners
To & Fiied in Dupliwte
CLAIM FOH HOMESTEAD PROPERTY TAX CAEDIT FOR YEAR 19 d�
SEE BACK FOR FILING INSTRUCTIONS
�(We) `��-� �� �`- � /d u- certify that on the 1st day of
March, 19 Sy I, (We) oc pied as our principal place of re idence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned 60�— 00��
❑ are buying under contract . -
❑ have a beneficial intereQst/ in the taxpayer
Property Description in �/-�--4-a-� County � �� Township
Taxing District (GFiy,-��ewn, Township):
Parcel Number
or legal description shown on tax statement:
Q,�. n1E ��F �O-�-io .707�
If buying Ofl contract: Owners name ��� simple owneq �
Contract recorded in Recorders Office - Record
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:
t is true, correct and complete.
�3
County Township
, CiN. stare ana
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 1(one) acre immediately
surrounding residential improvements
Other Land
Total Land
Residential Improvements Dwelling
� �����i arage
t�AP,'( �'t 1g�Z Tota�
Other Improvements
I��nprovements - Lip�jSf�e��ylsr (d�
by certify the above is�lTQftrec�nd complete.
Signamre oi
True Cash
value
(�> 3 Soo
(2) '
(3> 3Soo
ca� a �� � o
(5) —
�g� �2 '-�G i o
(�)
(g) a `iGio
- ACTION BY AUDITOR -
Assessed
Valuation
1170
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Homestead
Valuation
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Dare
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Approved: - �� Date: ��"' 2- 6 ' ��
Gibson County Auditor
101 N Main
PRINCETON IN 47670
�
2263
John R/ Beverly A Boss
111 Lake Inwood Dr
PrincetonlN 47670
�UR F[Knl!!H lti/Yrvl IPFTSUIFR f00.N i11A
InJrciduaL. anJ m�;riN touplo are limited �o orc home�ead .,unJard ANu:iion. As �he �ettipc of ihi� dcdunan bccomn
mure beneficial. Iherc u more incrnmr Ihan ecer for homrsieacl fr.mJ. Ilomr>�eacl &aud causes highrr b� bills ior all: thrrefwr.
HEA 134-1-71N19 requ'ues mipa�cn who reccive thc hnmesmaJ smndard JNunian to veritv ihei thev are eliciMe m mcci.. �he
brnefi� an1 w p�a'ide a�Wiiiu�ul iJentiirin_ iniomu�twn mcrvan� �o allw� rwnp� eucrmmrnt tu bener muniror homesrcaJ
filirpt+- lfiis infarma�im will M f.t7v cnn6demial mA can nnly !e accesseJ 6r au�hnr'vnt rnumr otl'¢iul�. TM1e Umanniem of
I.ucal Govcmmrnt Finam< ��ill mc �his iniormation w ar<acc twls tlut wfli h:lp camn' uliiaals dimiwm M�mat<ad (raud.
. • ' , ' , .
Taspeeer Name Prnpert�� Address
Boss, John R/ Beveriy A �
E� ll A�P-t�s c�ea:yc' H� E�,t i33
��� F� XE �N 1:1C`O � lie �nceton 1� d7670
/'2�uC e �cn �►�+ �767U
Sta[e Parcel Number Leeal Description
2fr12-Ofr201-000.183-027 006-001s3-oo PT NE 6 210 .7076 AC
___. ' __. > >_ V __ _ �� __--_— ___
cr 1 First
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Iig �ldu�w (numbcr wd'i�x: city. smrc. a-�L Z:P cod:)--
lodd 7� �z�n:t.6�c*�. �N 47b
Dmers License/Stam ID Nmnber Qu� 5 di:ils) Other (pltue
Address (Number ar/J rireel cil}', smle, and "LIP cale)
5
$nr�c ac pm]�crty eddrt: _ . _
Part 4
IJO 5 '
� S�une as propeny addrts�
undersigned certifies, under penalty of perjury•, [hat the aboae und foregoing information is tme and cortect and that he or she is zGefble to
�e the homeslead standard deduc�ion on this properly. Hach undersiened also unders�ands thal, by claiming addilional homestead deductions
�fully,i}e.�hrnt�y be liable for back taxes and substantial financial penalties.
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