Homestead_Burcks�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
:�� ��� � �
APR � �ulU
GIBSON Cp N� � q
UDI7Ait
tlaiE lOR��1!l V M IL /!µl
.\hMw EIl BT ci11E EINFDOf Y�[l� \T{. bn
: _ ,t�
lAfnNRfIIHHtV :}1/.
CM cLVM�A'T iY:AVCF M�I.1-}.-� 1
InJieidual> anJ ma;riN couple a�c limi�ed �o onc hnmtueaJ �andnN J:�luction. As thr reccipi ot ihis dcduaion bmomes
more bcneficial, iher< is marc incenti�x �han e�er for humesieacl fnud Ilomr��ead fraud causes higher tac bills for all: therc(wr.
HEA 1311-3fN19 requ'ves m�payen .ho recci.e ihe hanestcaJ si�ndard dNuction a.eriF �hat thcy arc eligiNe to meci.c ihc
benefi� an1 to p�a'ide a�Witional iJrntii��in_ infwmauun Mcrsan� ro allw� rwnn ga'emmrnt to bener monitor IwmesrcaJ
'nlim�,..'lltis inlnrma�ion will 6e lqV contidauial anA can only l� am�.nl hy wilroriud rnunrv o((¢inls. The Ihry+annrcn� of
Local Gmammrni Fivm'e ��ill uw this inionnation W aream twls that x'ill h;lp cvunrv officiaL. elimi`uic IpmcAead fiaud.
Tnsnacer N•ame Prnperte Address
Brucks, Jerry Don /
R31bx23
1'rincc�on IN 47670
2213
Jerry Don / Brucks � nd ��
�- � ( 3 E ci�Fr .
Princelon IN 47670.8609 V" State Parcel Number , _ Leeal Description �
I�I��II���I�II��I���IfI���I��I��II��II���I�I����II����III�I��I Zs-iz-OS40o-gOOZ24-027 oos-oozz4-ooPTSE52101.8287AC
J `-'
����R �
�� �
y(aum6..-ra.d� �t.ciry:s:cf_:andZ!Pcoc:) '—
' Numbcr (last
Fach undersigned certifies, under penalty of perjury•, that the abovr and foregoing information is we and cortect and that he or she is elieible to
receive the homesiead siandard deduciion on this propeny. Each undersicned al;o unders�ands that, by claiming additional homestead deductions
unlawfully, he or she may be liable (or back taxes and substannal financial penalties.
Owner I Siim.. D-te Telephonc
��� �� �,,..,���� -o � ae/d �
�
�
�
warn xc io ism ro se Faea �� worwre
PreuribeE By State BoarO a� Tax CammiSSioners
CLAIM FOR HOMESTEAD PAOPEATY TAX CREOIT FOR YEAR 19�`L
SEE BACK FOR FILING INSTRUCTIONS
�(We) Q'*���- ;�� �✓ ��� certify that on the 1st day of
�arch, 19��L, ,(We) occupied principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) �owned oQCY-o oaa y
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in �d—� County `�a.-��.a� Township
Taxing District (City, Town, Township): ��-a �t.c.�-o
Parcel Number or legal description shown on tax statement:
�� S E�i� s- �—i � /: � a I4.
If buying on contract: Ow�ers na
Contract recorded in Recorders Office - Record No
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
I hereby certify the above statement is true, correct and complete.
� / .. /� � �� -� ./J . ,.-
Aaaress
L17G�°
Ciry. S�aie ana Zio �e
�la8'17 �
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(�) a�re irrfinediate}y �
surrounding residential i rov�"e�ment� �
Other Land
Total Land ,;;;\! � s; ig��
Residential Improvements
elling
�, � age
(�f� AUDITOr�otal
Other Improvements
Tntai .Improvements - Line (6) plus (7) equals (8)
I.��y certify the above is true. correct. and complete.
Assessor
Approved
True Cash Assessed Homestead
Value Valuation Valuation
(t) 30 0 /�°
(2) 30 0 �a o
(3) d e
(4) 2X7o
(5) —
(6) .2P7o
(7) 020 0
(8) 3070
- ACTION BY AUDITOR -
jjj�pj��jjjjj/
���j����
�
�,.
�.
/•
_•
S- �-r -7 5
oa:e
/ '�G.
Date: L!/