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Homestead_Burriswan� xc io ism NesaiME By S�ate BwrE ol TaK Cammis5ioners To & FileG in Dupliwte CLAIM FOfl HOMESTEAD PROPEHTY TAX CREDIT FOR YEAR 19� SEE BACK FOR FILING INSTRUCTIONS e�(We) /�-�-a� � Q- f �"""°""yN certify that on the 1st day of arch, 19�2, I, (We) occu ed as our rincipal place of r idence the following described real property for which a Homestead Property Tax Credit is hereby being claimed: I, (We) ❑ owned / '/ ❑ are buying under contract . O D(p " Q ��'7D ❑ have a beneficial interest in the taxpayer -,- L Property Description in �-�-�� County �`L`"`�-"� Township Taxing District (City, Town, Townshi : � ��� Parcel Number or legal description shown on tax statement: Q�F . illuJ ��`f $- i—i o � a if ) If buying on contract: Owners 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 �eal property: ment is true, correct and complete. �__ Sueet AEareu County Township � Ciry. Stare and Zip CoCe ual 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 -QSSESSOR'S USE ONLY - t True Cash Value Land not exceeding 1(one�) acr�e immetliat�G.Y� surrounding residenU� improve(�ents � €� �# Other Lantl �� � �� Total Land � ,,,� c 1�j� .,u�d 2 • - Residential Improvements Dwelling � �r ���ti��,�yGarage �/i' Total ji �UDITOR Other Improvements T�Improvements - Line (6) plus (7) equals (8) I by certify the nbove is true. correct. and complete. Signawre ol assessor (t) 900 (2) 900 (3) / 800 (4) a/8G� (5) — (6) �/ b'Go ��� i So (g� a 2 O 'fo Assessed Homestead Valuation Valuation .. ', ���������� - • ' ���������� ��������� ���������� ����%///�� �i���/�% � -_ ' • – ��. ;� .. ��jjj�j�� �'� - jjj���jjj • Date — a9—� ACTION BY AUDITOR - Date: tl � ?' �� 7� t � Gibson County Auditor 101 N Main PRINCETON IN 47670 3395 SL�iEf00.M!!M�0./��NI irr-nwararoad:su 6�dinduaL. and inarrinl mupla arc IimitN io nnc hnmcveaJ vandaN dMunioa As ihe receip� 01' �his dcduriion beconm. morc bcnencial. thrrc is morc incentn< than e�er (or home.vtrxl frauJ. I lomei'rcad Bawl causn hifhrr ta� bills for all: ihercfwe. Hl.1 I3-t3-?0(!9 rtqvirts U�payrn r.ho receire Ihe hanestead <�anda�J Jnfunion m.erify dwi thry am elitide to recei.c �he benefii anf to p(w�idr xkii�ional identiiyine in(umxroiun Mcr.'vrr to allw' eounn� gmemmrnt to betrcr munimr humese:rJ filin��.'Ihic infmmatinn vill M1r lqv cmli�irnti�l anA �n only M acce+.eJ Fy awM�iiN rnunry� officiai..'1 hr Ury+annrcm of Local Gmartvnem Pinance will u�c ihis infmmation tu treatc twls �hat �vill h:lp aam�� otScials diminvc homatcaA fnud. .,' ,. , Taapa��er Namr Propertr Addretis Burris, John J / Carolyn _ a IR9 John J / Carotyn Burris 8.2-8az'�8�— PrincetonlN 47670-8829 ���u���n����u�ui���in�n���n�in�i����n��ui��ui���u� JoNa �% �c Addrt�ss (numbcr und �traY, eity, smic, and ZIP cade) /700 � srfl� %��Q � Sccurily Numbcr (las 5 digiis) Urivtt's Lic nx/Siale ID Number Qut 5 digiu) ���.o�y,� State Parcel Number 26-12-09300-000.240.027 Y I'rintt�lon 1��76j0 � �� V i � (a / Le�al Description 006-00240-00 PT NW 9 2 10 2 AC �u�ls Same ns prapcm adMa; Other (pieue specify in Part 4 � M�aai< Addrcss (Number and e�trccl cii}', sutc, nnd ZIP cale) /%DO � Si 19� I �C �� tturiry Number Qaz[ 5 digi�s) Dmcrs LicrnsUStatc ID Numbcr (lazt 5 digits) O�hcr (plcasc ., � ���Q�s � $:�me as p�apeny address Pan a undersigned certifies, under penalty o( pequp•, that the aboae and (oregoing informatiun is We and wrrzc� and that he or she is elieible to re the homestead siandard deduclion on lhis property. Bach undersicned alio underslands lhat, by claiming additional homestead deductions rfully, he or she may be li�e for back taxes ;u�d substantial financial penal�ies. _ �—/6 --/� '�-yL� � o (�