Homestead_HellumsC�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
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IndiviJuaL anJ rturtied coupk. arc limned �o oce homc�caJ �andaN dcdunion. As UNC receipt ol ihii Jeduction becomn
merc benrficial, thrrc i> morc incenme tlun r�<r for homestead traud. IlameFead fmud causs hi�her Ia� �iills for all: therefae.
HEA G33-20LW requi¢s uxpayers who recei.r ihe hanes�md sundard deJuc�ion �o .rri(y that they ye ;li_iNe to recene the
benefii aN ro p�w'id< additional idrntifiint informatron necessan' ro allou' counn� �rmment ro beurr monitw homesead
filin��. This infomulion will M Aryv crnfdeniial and on oNy lx: atttc�ni br aulMri�d rounty oilici�l> The Ikpanmmt of
Lxal Gov<mmrn� Pinance n'ill u.c thfs fnfonnation W cream [ools �hat aill hro ramn' offi�als dimiwrc homesmaA iraud.
500
Anthony W Hellums
1784 Conwrd Dr
PRINCETON IN 47670-9332
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Taxpa��er Name
Hellums, Anthony W/Sondra D u
G v
State Parcel Number
2fr 71-14-101-000.243-027
_. _ _.✓_ __ . __
17s4 Co
Princc�on
This form MUST be retumed to County Auditor's office.
Please do NOT send this farm back with your tax payment to the county
tig Add�ess (numbcr'end iVCC[, ciry, smtc, snd ZIP coJc)
/� 3 i w 6,�� �;� io ,n �-e}
d$ceurity Numbcr Qast i digits) Dri��a s LiamdStak ID Nmnbcr (la
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Mailine Address (�umber and SyrceS city, siate, and "LIP code)
183 � w 6�.�r �,,,.k,,,. P�:
`,u � if���
��emc az property sdd�,
N 4��, �
Other (pleaze specify in Part 4 bebw)
M�aai<
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I�e u pmperrv ad�Less
Ifff
lj
UR
VILLAGE SEC 2
surer.
Joc�al Sttunty NumDtt (last 5 Ai¢its) Dm•cYS License/State ID Number (la.i 5 digits) Other (plrsse specify m Pan = beloa�)
_
-- — � �
Each undersitmed certifies, under penalty of pepury, that the abo��e and foregoing information is we and coirect and that he or sNe is elieible w
receive the homestead standard deduc�ion on this property. Each undersiqned also understands that, by claiming addi�ional homestead deductions
unlawfully, he or she may be liable (or back taKes and substantial financial penalties. I
Owner I$icmnuc � Unte Tdephone �
c�-�o�io
lJ l�ck�l',�.� I�-��- i o
�� �'� � ��� `
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; CLAIM FOR HOMESTEAD PROPERTY iAX
' CREDIT/STANDARD DEDUCTION
t .� S�aie Form 5473 (R6 / 4-03)
Prescribed by Ne Departmem of Local Govemment Finance
INSTRUCTIONS: See revcrsc sidc loi /ilinr� insliucfir�ns.
&`� z�=;S:it``�_= �'�'•<� ,�,�hYa���: _:�-�- � . `:i;"�`_.- - -' , CERTIFICATION
�
�
FORM YEAR
HC10
� Y
1
� �f'
I(We) Vv M /� K�^' � �VV�Ll.�+ p�� /�j�C-r-r��ertify that on the 1st day of M�arc�hJ 20
I(We) occupied as our principal place f esidence the following descnbed real property for which a Homestead Property T�c�u' '�Fid��Ct{29aimed:
❑ I(We) owned ❑ We buying under contract �/
GIBSON COUNTY AUDITOR
, Nave a benefidal interest in the entity that is liable (or the property taxes on the property and Ihat owns the property or is buying under a contract.
.�.r�.c'-.Tr. ��s>?'"e, cr,+„ . ,.> � 1 � s; � <- .e�a�'�. ;:�"-CONTRACTRECORDED''; ;- �. . _. . . -. - . .
- ,:e.. r. -.. . . - =-. .
If buyvig on contrad. Fee Simple owners name
Recoiders olfice where contract is recorded Record number Page
- ^ .., '-'x^.. '-:r' . .
Coun Tavnship Tacing di5tric� (cify, town, ow hi )
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Parpe� nymyer ���� � Le9al d 'ptio �/ Is the property in question:
v � O i., V
�i �[J" Real praperty ❑ hlobile Nomo (l.C. 61. f-7)
If any portion ot Ne resiAential strudure w the IanE not axceeding one (1 � acre that immediatey su unds thai s aure is usea to D��ute inmme, tlescribe the use and ponion
of the properry utilized to praduce inwme.
County
Tavnship
I hereby certify the above statements are We, covect and wmp�ete.
ress (number and sfreef, ury, fafe, ZIP code1
� _ � .. O I � /S . \ f'1 ; ' '
:AIMANTiN���OTHER'COUNTIES'�'""''"� ;
Couniy
Signa W re ol claimant
� n C-e. �on � N
ioxnship
k���0
T,p._-'"� y i°' ASSESSOR USE ONLY �. , .,TRUE TAX ASSESSED VALUE .� HOMESTEAD' ' NON-RESIDENTIAL�,
�'..,. � . _,_ +��=. . �-:..,-- �� : ' " VAI.UE �. . AT100%OF:TTV.. �'� � VALUE -c� . .�_ .,._r�;'VALUE��.. "-�_..- ��
.< x� e.tti
Land not exceeding 1(one) acre immediately x- -�- .-
sunounding residential improvements. (�) . � , � I
Other land . (p� - ` .
Tdal land (line 7 plus line 2) �3�
Dwellin9 (4) . � �+',�r r .. -
Residenlial improvemanLS or Mnualiy "'
Assessed Mobile / ManuFacturad Home 9 (5� `�'�' y�'� .� -. -
Gare e ,.s_. _.
Oiher improvements (6)
Tdal improvements (line 4 through line 6) (7�
Tctal value (line 3 plis line n (8)
I hereby certify �he above is We, cortect, and signawre otqssessor oate signea
complete.
Vailying action - SignaWre of fwditor Date si9ned .
20 _ Pay 20 _
Lesse� of 1/2 Homestead
wuauon or 535.000
3
I Date sigpe� �_ O� I
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