Homestead_Christy (4)FOpM HC 70 7979
hescriCed By Sutt Board of Tae Cammissioners
To & Filed in Duplicate
CLAIM FOR HOMESTEAD PROPERT.Y TAX CREDIT FOR YEAR.19�
SEE BACK FOR FILING INSTRUCTIONS
�(We) '� certify that on the 1st day of
March, 19�., I, (We) occupied as o r principal pl ce of residence the following described real property for
which a Homestead Property Taz Credit is hereby being claimed:
I, (We) Q'owned
❑ are buying under contract OO6 ' 00317
❑ have a beneficial interest in the taxpayer
Property Description in �/�-� Cou�ty `��-4� Township
Taxing District (City, Town, Township): ��� �.
Parcel Number or legal description shown on tax statement:
� pE . nr ul 'i� N C'�5� �3. 3, 5
� PL. NF'iw n/W!v Tac,t �3-�f /S-2 �o
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 real property:
� hereby certify the above statement is true, correct and complete.
i �. .
County Township
IyQF�-./� �'-�%�/ ./ o Sveet Aoaress ' GY. State aM Zio CoCe
v rii..,:y��
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' 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 q��
Other Land � � � � 1 i
Total Land g�
Residential Improvements
Other Improvements
JLIid � � �91�.+�elling
/�� Gar e
��
AUDITOR
�T- ,� Improvements - Line (6) plus (7) equals (8)
eby certify the above is true. correct. and complete.
Signawre
True Cash
Value
(i) Soo
(2) a3 /o
(3) �P / o
(4) �+2 0 (o e2a
(5) —
(6) .�O (n 2a
(�) S�o
(8) 020 6 "(o O
- ACTION BY AUDITOR -
Assessed
Valuation
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Date:
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Homestead
Valuation
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Gibson County Auditor
107 N. Main Sireet
Princeton, IN 47670
� FILEI�
_ ° APR 17 2012
_ c.�.m�
GIBSON COUNTY AUDITOR
3487
iar,asuua roxv �sin
Indiciduals xnJ marrieJ couple� a�r limicttl w one honRS�rad st:uwUrJ dnluctiun. .Li �he «crf{u of :hi> deJuctiun Ixcnnie�
mo¢ Mncfivul, ilwn is morc ir.ccnti�c dun crcr lor hom:>n�ad GauJ. Hiuncst_ad tnud c��ss ni¢M1cr ta� bills (or ell: th.refom.
HEA 137J �OIW reyuirs uzPaven wiio �tteire :M1r homenead .�anJael dedu<tion m cerify �hat Jx>' art eligihlr ro recci�e �he
h�rcfii aml to prm�iJC afdi�ioml idcmi(ying ir.fnrmauun nc:c.wrr io alimv rounn• eunmmcm to lii�R m.mi�ar homcacad
filinu.'fhi> in(amu�ion .vill br Aeq cmliJential and c�n only fK attr..ed br auehurized counry nlliciala The Depanmem of
L�xai Gnvcrmrni f"inancc �dll mc tl�i. infarmation io o�uir wnh thai �vill hcln mumm �lGcul. climin�lc hmnc.�cad IiauJ.
. ' , , . '
Taxpaver Name Location Address
Christy,Kenneth/Peggy
Kenneth / Peggy Christy
3121 E Top Hat Rd
PrincetonlN 47670-8861
���i�l��ii���l�����ill�lil�i�l��i��ii���llli��lll�ii�illlill�ll��
3069 E TOP HAT RD
PRWCETON IN 47670
II�IuIII��III �II I III uIl IWUIIlOI�IIWII��ll�ll�ll�lll�lll�l ulu II uIl�Ilulul0ll II
State Parcel Number Leqal Description
26-12-15-200-000.317-027 PT NE 15 21013.7412 AC C-1
0
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
Addrtss (nwnbcr and sveet, cily, sla:<. and ZIP code)
'ial Sccuriry Numbe: Qu� 5
Add�ess (�ur.�er.nd ssm, cil}', stale, and ZIP crode)
?l �. �P l�a. f ��
uriq� Numbcr (last i digia) Drivcr s Liccnsc/S�arc ID A'umba Ilaz' S
u5�mc u
/ .�
is) Othe
Su¢
Middle
suP_
ir. Part 4 bclow)
I�f Same as pmpeny add:ess
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undersiened cenifies, under penalty of perjurv, that the above and foreeoing information is we and cortect nnd that he or she Ss eligible to
•e Ihe homestead standartl deduction on this property. Each undersienecl also understands that, by claimin¢ addi�ional homestred deductions
•fully, he or she may be liable (or back ta�ces and substantial financial penalties. � � o
I SiFrrmmrt����c Uzee Teleplro�e
�s�, .,�.�.� �/��/IY �u �� _�� (�