Homestead_DaydE�'� i CLAIM FOR HOMESTEAD PROPERTY TAX FoRM YEAR
;��: CREDIT/STANDARD DEDUCTION HCio
�,,�� State Form Sa73 (R2 / 5-92)
Tu�
INSTRUCTIONS: See reverse side �or liling instructions.
I(We) � certify that on the tst �y of March, 19_
) occupi as our principal place of resi ence t following described real property for which a Homestead Pr rty Taz Cr 1 ish'ereby claimed� �
� � Lfi �
�, I(We) owned ❑ Are buying under conirac� . ,��,v- ), ��,`
� ' __.' �rf.:,.�.✓..•�r�rno
❑ Have a beneficial inierest in the entiry ihat is liable tor the pmperty taxes on the property and that owns ihe property or is buying under a�contra�
' � - - CONTRACTRECORDED '
It buying on comract, Pee Simple owner's name � . , .
Recorders oXice where mntraa is recordetl Record number Page
'� PROPERTYDESCRIPTION
Township � Tazing distdct (
Par Legal descriptio ( /� � ��
��-c�3isa f t�/ NL �� - a - . ��r
If any portion of the resitlential stmaure or Ne lantl noi exceetling one (1) acre that immetliatety surmunds that 5trucNre is used to produce income, tlescri6e Ne use antl portion
of ihe property utilized to produce irwome.
. ASSESSOR USE ONLY TRUE TAX ASSESSED MOMESTEAD NON-RESIDENTIAL.
� _ VALUE VALUE VALUE VAWE ..
Land not exceeding 7(one) acre immediately
surrounding resideniial improvements. (�) ' �
Otherland (p)
Total land (line 1 plus line 2� (3)
Dwelling (4) . -
Resideniial improvements
Garage (g) .
Otherimprovements (6)
Total improvemenis (line 4 through line � (7)
Total value (line 3 p�s line � (g�
I hereby certify ihe above is true, correct, and Sgnamre of nssessor oa;e signed
complete.
Verityirg action - Sgnamre ot Autlitor Dare signed
�
�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
1903
) id H Day
73W75S
�rinceton IN 47670.8142
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TPfItUIERN]0.V �YIA
IIRALLV�26YMR.TiR:MCEICSIJ � �J
InJi��iJuals aod ma;riN coupk. are limi�td �o onc homc9eaJ �a�nl ��Iu��ion. As ihe recript of ihi� Jtdunion Lxcomcn
morc 6cnencial, thrrc fs more inrrntnx ihan aer (or homestraJ Baui Ilomeireml fraud caust hi�her ta� bills tm all: therefae.
HEA G3�1-30(19 reqvim u�pa.en �ho rcceivc Ihc hnnestced siandard deJuction �o arily tivt �hey arc cligiNe io mcenr ihe
brneF,t aN to p(m�idr �JdI1WNl identin'i�m infwma�iun �c�-vn� io allw� counn ewrmment �u benrr munimr honxse:d
tilirqn. Il�is inlamution x�ill M Aery cmlidwial anA can only M: arceoed M1v amlro�vN rnuniy nfTicial..'Ihe Ikpannmm of
l.ucal Gwernnem Finmrce will ux this into�ma�ion tu crcam nvls that will heln cnuntt uhTicials dimi�um humcucad traud.
n�y���n�u����u�������ni���
Tasnaver Name Prooertc Addre�s
Day, David H
Rrdl3ox 19i
Princeton IN 47670
State Parcel NumAer Leeal Description
26-11-16-200-003.152-027 006-03152-00PT W NE 762 it 1.646AC
D-77
V
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Owner I First hfiddle Las�
DA�� D f� D�4Y
�g Addmss (numbcr and srim. ciry. stdrc. �end �ZIP codc) ' _ __ . _ _ _ _ __ . _ � � Snma a; prapen� adw'—. _.�.. . - . _ .
3 8�� ar �S s P/,�eErO�✓ �N, c� 7G �O
Middlc Lact
Mailing Address (Number and s1rre4 cit)', sm1e, and "LIP cale) �$ame si pmpeny addv�'
Social Stturiry Number (las[ 5 digiu) Drivers LicensGSute ID Nwnber (last 5 digits) Other (plcase specif� in Part 4 bclow�)
sor
. . . �
Each undersiened certifies, under penelty of perjury, [hat the abovt and foregoing infurmxtiun is we and correct and that he or she is elieible to
receive the homestead standard deduction on this propeny. Each undersi¢ned al;o undersiands that, by claimine additional homestead deductions
unlawfully, he or she may be liable for back taxes and substential financial penalties.
Ou'ner /I S1i�,manue Ihte Tcicphme
,V,�;/ y/a, �o (
Spoux Sip�aturc Uate Tcicphcmc
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