Homestead_Creek (3)a� "� v CLAIM FOR HOMESTEAD PROPERTY TAX
���� CREDIT/STANDARD DEDUCTION
�;;�� Stare Form SE73 (R2/ S92)
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INSTRUCTIONS: See reverse side lorliling instructions. AUDITOR U
� - . � � CERTIFICATION STATEMENT � ^ - - � . ��
�I� e) � T o a.k'� s.� � ��y .� .J certity.that on Ihe 1st day of March, 79
�) occupied as our inci I place o( residence ihe fo�lowing described real property for which a Homestead Properry Tax Credii is hereby Gaimed:
� I(We) owned ❑ Are buying under contract
❑ Have a beneficial inierest in ihe entiry ihat is liable for the property taxes on ihe pmperty and that owns the property or is buying under a contraci.
- ' - � COMRACT RECORDED- � � � "
It buy"ug on contrect, Fee Simple owner's name
Recortler'S ottite where contraa is recorded � Retord number Page
Counry
Parcel number
TownsNp
Legal description
PROPERTY
dis[riCi (ury, town, township)
�oco- �ctiyt�y-bc� �
If any portion of the residential strucWre or the Wnd not ezceeding one (7) aae ihat immediatety wrrounds that swcWre is used ro produce income, descnbe the use and portion
o( ihe property utilized ro produce income. _ �
ASSESSOR USE ONLY � _ TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL.
� VALUE VALUE. VALUE VALUE
Land not exceeding 1(one) acre immediately -
surroundinq residential improvements. (�) '
Otherland (2) �
Total land (line 7 plus line7� �3� �
Dwelling (4)
Residential improvemenis , .
Garege (g) . -
Other improvemenis (6)
Total improvements (line 4 through line � (7)
Total value (line 3 p�s line � (g�
I hereby cenify the above is tme, correct, and Signamre ot Assessor Date signed
complete.
�tying action - Sgnature of Autlitor � Da:e sgnetl
1
19_Pay79_
Lesser of 1/2 Homestead
Valuation or 52,000
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° GibsonCountyAudi[or
101 N. Main Sireet
Princeton, IN 47670
2176
10.TNRlA100.11SIA
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IndiviJual. anJ marrrt�l couplo are IimitN [o nnr Ironkstr.ul >tanlud dnluctiun. :\. tF.e raeipi of [hie dNuction 6�eome�
morc hncncial. Ih�T is more ir.crnG�e �han cctr lirt hom_mnd fr�ud. Flumc�cad GauJ a�ua. Sichcr u� bili• (or:IC thcrrfom.
IIIS\ 13J7-]�M19 rryuir:s u�pareo wio n�cive [hc homc.naJ uanJscl dniuction m cerify ihat thcy a�e eligiMe m rccei�r �he
Mnclit aM ro p�m'iJc aYlf�imal idrmifying lr,ti�rnniion nc:a.an� io aII.TM� cvumy ¢w'cmmcm iu Cu¢r muiiior homcacad
filir.u. �Ihu infomu�ion will be Arp cmfulential and can onh� h x-�r.,N lx auduizcai rounn� ollicul>. The Depannmm of
LnuN Gueerr.r,km Fi`unn ��ill ¢ c �hi. in(ortnatinn m cr��r irolc :hat aill hclp cuunn� nfTcial. <limiru�. Mmn�caA Inud.
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TaxpaverName LocationAddress
Creek, Mac A/ Katherine S
Mac A! Katherine S Creek
2540 E Tafttown Rd
Princeton IN 47670-8615
��I'�IIIIII�"'�II'I�I�II'�"'�I�'lll'I"'��II'I�'�'lll�l�l�"I�'
2540 E TAFTOWN RD
PRINCETON IN 47670
I I�I �II� II I I��III �I� II� II� �II� II� II� II I�I� I I� IIW I I�II� II�I �I� II II
State Parcel Number Leqal Description
_ . 26-12-03-100-000.404-02�T N`N� 2�353�
I
MAY 0 9 2012 '
P1
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This form MUST be returned to CountyAudit4,r,'��f�i�,AUDITOR o
Please do NOT send this form back with your tax payment to the county treasurer.
�r a�d svctL city. sta:c and'LIP tadc)
� � / a �o W �/ �cL
(last i dieits) Ihirer's I.iccnsc/S�ate ID \ur�er (4ts: 5
�h�-�2 � N e... - _ !
(\ember xnd sJwt, ci�y. sam, and 7IP code)
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lD Number (laz; 5
pmpcm� add.�css
opsifi• ir. Pan 4 bclow')
N ISU�e
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li ISawe-es�propenyadd.�ess
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spcciC} ic Part 4 below)
undersiened certifies, under penalty of perjury. that the above and foregoing information is true and cocrect and thai he or she is eligible to
re the homestead standard deduction on this propeny. Each undersiened also unders[ands that, by claiming additionul homestced deductior
rfully, he or she may be liable for back taaces and substantial financial penalties.
1 Si@�ulure
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