Homestead_Davis (24)FOflM HC 10 1979 '
HescriDeG By Sute BmrE ol Taa Cammissioners
To & FileG in DupliWre
CLAIM FOR HOMESTEAD PAOPEATY TAX CREUIT FOR YEAR 19�
SEE BACK FOR FILING INSTRUCTIONS
'�(We) �� �- kQ-Q-��+� certify that on the 1st day of
��narch, 19�4, I, (We) occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) B' owned �q (� � �3
❑ are buying under contract U l�
❑ have a beneficial interest in the taxpayer-
Property Description in � County `�a�-A-tti Township
Taxing District (City, Town, Township):
Parcel Number
If buying Ofl contract: Owners name ��� simple owne�l
or legal description shown on tax statement:
Pf �vc ��� i9-a-,� � r?.
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:
�hereby certify the above statement is true, correct and complete.
/�,/ _ I i 1-9,� � � o � { ,
County Township
�67d
--� 'SignaWre Sneel Aaaress ' ' Ciry, State ana 2ip Coce
�/%��9
' 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
surrountling residential improvements
Other Land
Total Land '$ � � �
Residential Improvemen � �, Dwelling
n
�t�(� 12 5979 Garage
Total
Other Improvements � �����
� 'm�t
To' ' Improvements - Lin ) plus (�Veqva�s (8)
I��y certify the above is true. correct. and complete.
Signawre �i� Assessor
(�)
(2)
True Cash
Value
r.�
(3) SOo
(4) �/ p /O
�s� —
(6) .2/b/o
(�) /90
(8) �/.� 0 0
- ACTION BY AUDITOR -
Assessed
Valuation
/70
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Da�e
Homestead
Valuation
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Date: � —/ Z- 7�
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
4013
V�den Lee Davis
334 E 200 S
Princeton IN 476
I�I��II���I�II��I���I
�I�IE fO0.N al.'MIti/Yrvl
.\��WT'EDBT��\It:BnUOM/C!'!r T�.F��/
iRE4ti11RfRPoR4:R1A
IndiviJuals anJ marricJ <oupk�. arc limiied io onc homcucaJ siandiN J:dunion. As ihe receip� M �his JaYluctinn btrnma
more beneficial. thrrc u marc incentire dun rcer (or home>teaJ trvud Homn.ead frauJ cause hi�hrr ta� bills (or all: the¢(orr.
HEA 1337-?009 raquim d�pa�rn x�ho r•ceivc Ihc hanestrad qyndnd Jttiut�ion m vcrif} Ih.+� ehcy am eliciNe to mcei�e �!re
benefii �N ro pnn'idr aiMlitimul idrntii�in� fnfumiauan �xcrvn ro allw� caunty �nemmrnl eo betrcr mmitm homeseaJ
�ilim�. lliix inlnrmninn xill br Aqv cun�idavial nnd can nnl�' Fc acrec�eJ by aulMried rounp� M7'mialc. The Ikptnnmm nf
L�nal Guvammem Finance �vill mc this mtormation W crcam t ob �hat o�ill h:lp counp� ufficials dimin.vc homcshad haud.
, • ' , , , .
Taanacer Name Prooertc Address
__ Davis, Vaden Lee/Judy Kay_ __ _33 4_t �D S
R I 13oz 271-a
�PRi�C��\ I\ �7670
� State Parcel Number
'I II II I I II I II I I Zf'�2-�9-z00-000.433-027
i nn i i ui u n u u u �
icr I
la de�1
'ng Addmss (numbcr end >umc, city. �mte.
3 3 �f � �d0 S
�e�
�%�/ �iY,'/ °N
ID Nmnbcr (Iv.15 digits)
� Kdy I �« y
ine Address ( umber and sYree4 ah)'. sWle, and "LII' cuik) �
3 C aooS �',�c�etz�
il Securin� Numbtt (last 5 diei�s) Dm•crs Liccnsc/S�a[e ID Niunbcr (la.t 5 digits)
� ���
J
�N
Otha (ple�se
Leeal Descriotion
0060043300 PT NE 79 2 10 5.207 AC
D10
,c��r d% f
Jamc ns pmpem oudtiv� —
j�7v
fv in Part 4 bdow)
,c�� v�f
� $�me u pmperly add'a.i
dN � �G � U
Othcr lolc�sc socciE in Part 3 bclox��
undersigned cerrifies, under penalty of pepury, that the abovr and foregoing infortnation is we and cortect and that he or she is elieible to
�e the homes�ead standard deduction on this propeny. Fach undzrsigned al;o understands �hat, by claiming additional homestead deductions
rfully, he oyshe may be liable for back taxes and substantial financial penalties.
I
ate Iicicphonc (.