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A�rypYIO lY BTAYB B�Aep GY ACCOLRY/. MAY Sffl FORK RC 81•W 4ss�-I <br />RECEIPT FOR PAYMENT OF INDIANA GROSS INCOME TAX ON SALE OF REAL. ESTATE <br />Gurley Deep Buick, Ine• Receipt ly ? 317197 <br />,Grantor <br />RECEIVED OF <br />South Bond St. Joseph Indiana <br />ADDRESS CITY COUNTY STATE <br />o ; <br />=r , <br />0 <br />k - <br />F <br />d <br />�H <br />pifteer. cents------ .15 <br />DOLLARS <br />5t.3oseph <br />INDIANA GROSS INCOME TAX ON SALE OF REAL ESTATE LOCATED I COUNTY OE <br />DATE danuz.ry 24' � , County Treasurer o <br />10.00 <br />Tax paid as evidenced by this receipt is based on taxable gross income in amount of $ as declared by H <br />n in such declaration. <br />above named taxpayer and is subject to adjustment in case of error or misrepresentatio <br />