HomeMy WebLinkAboutHomestead_HaleyfOPM HC 70 1979
PreSCribeE By Sute BoarC of Tax Commissioners
CLAIM FOR HOMESTEAD PflOPEflTY TAX CREOIT FOR YEAR 19 �9
To & FiIM in Duplica�e
SEE BACK FOR FILING INSTRUCTIONS '
��(We)—,� �~'"`�""-` `�• ��� �• certify that on the 1st day of
arch, 19�22, I, ( e) occupie as our principal place of residence the tollowing described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned �Q�p'D� 73 �% '
❑ are buying under contract .
❑ have a beneficial inte¢re/st in, the taxpayer .
Property Description in ;�-�--�^-¢--P=^--� County ��a-- Township
Taxing District (Grfy�awrr, Township): ����-ti—
Parce� Number or legal description shown on tax statement:
PJ.NW�/y �_ �-,o b.oz�ea
ii n-,a ,iSSyp L�i/3YA
O r A/ W Y L
Ii buying on contract: Owners name (�� simD�e owner)
Contract recorded in Recorders Office - Record No. Page
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: County Township
�hereby certify the above statement is true, correct and complete.
�i.u.-c.a pZ°wv.�,
�,,,.. w d% Q e� � �3
�
Sute an�
' 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
Land not exceeding 1(one) acre immediately
surrounding residential imArave�nts � � �
9
Other Land t9
Total Land
Residential Improvements
Other Improvements
,IUN 1 4 1979_
Dwelling
e
� � �6E�a1'
AUDITOR
To� � Improvements - Line (6) plus (7) equals (8)
I����y cerlify the above is true. correct. and complete.
Signamre ot nssessor
r
ONLY -
True Cash
Value
(�) 3so 0
�2) � %D
�s> y3 90
(a) .� � Li � o
(s) —
cs� �a�so
(7) �8 <� o
(g) �{a3/o
- ACTION BY AUDITOR -
r
Assessed Homestead
Valuation Valuation
. .
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Daie
Date: � ^
•
Gibson County Auditor
101 N Main
PRINCETON IN 47670
897
lliTE11111M�!Wlti/!�+�1
iRFATUAER W0.N .'l-. IA
IWiviJuaL anJ rturriN coupk� are limited �o onr homeueaJ ,�andartl �L^dunion. As the rmtip� 01 tltis dNunion beconxm
morc beneficial, there is morr incentnx than e�er (or humesmaJ Gaud. Ilomesttael f`aud cau�es hi�her ta� bills (or all: them(ore,
HEA li�-1-20M requirt5 �a�paycn x�ho cemivc Ihe hanetteaJ smndard JcJutlion �o cerily �hn �hey am cligiNc Io mccne Ihe
benent aN to pnn'iJe aLfiiional identin�irc� infwmatian necr'vn� to allw� rounry gu�rmmeni ro betrcr muniror Iwmrsead
�iling<. Iliis inlormalinn will M le�x mnlidemial mA r.in only hr. acce: ud A�� authorizeJ rounw nffmi�nl.. The Ikpanmcm of
Lmal Guv<rtvnem Fina�rcc will um ehi5 intofma[ion w arca:e twis that will h:ln nounn' oliiciaLs clfminarc Iwma�cad fiaud.
I' i ; ' �,,.
qpR g [uw
Doyne W/ Shila G Haley
Po Box 1295 �(a� ,Q �
Princeton IN 47670-0995G g N� �J p
I�IiiILiilillnlnilllnil�iiilfiluPlii1l�IUliIinIAIUI�IuIR
Taxoacer IYame
Haley, Doyne W/ Shila G
�
State Parcel tiumAer
26-OS-40-194-000.738-027
V
c
Princcmn IN •17670
Leoal Description
006-00738-00 PT LOC 194 1 10 77.4383
AC C-1
1• �
O�.�ner 1 First Middle Lut
D o yiv E �.1 � �caeo /�/�e.Ey
g Address �numbcr end simt, cirv. sra�c, and ZIP code) — Pf e p t nt V A dd f eS5 � � O Sume u; p�o{µrty W.Lus — —' --- - -
Pr/nccion Sqd /O 8 W O�DE�-[..
P � (� oX / Z 9$� •K 767o P,q/NGET�/.+ 2ND 9670
$ocial
Middlc last
g / LR GA LE HFLEY
Mailing .4ddrtss (�umber and �Vtt1, cily, sm1e, and'LIP cak) � S�une az pmpeny addrcs
Q,b. Bex /t4S
PR/NCE7'bN Sn�D �^/670
Social Sccurity Numbcr (last 5 digits) Drivcr's Licensc15Um ID Numbcr (1a;t 5 digi[s) O[hcr (pinsc spcciN in Part 4 bclow�) .
�
Each undersigned certifies, under penalry of perjury, that the abt�ve and foregoing infortnation is we :�nd correct and that he or she is elieible to
receive the homeslead standard deduciion on this property. Each undersiened also understands lhat, by claimine additional homestead deductions
unlau�fully, he or she may be liable for back taxes and substantial financial penalties.
O..ncr 1 $i¢nature Uatc Telephonc
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