Homestead_HelsleyF9RM HC 10 19i9
PrescriEea By Siate Boara ot iaz Commissioners
CLAIM FOR HOMESTEAU PROPERTY TAX CREUIT FOR YEAR 19 $�
io 9e FileO in DuDlicate
T�(We) � ��- �• certify that on the tst day of
March, 19� � I, (We) occ ied as our pri ipai place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
❑ are buying under contract .
❑ have a beneficial interest Qi.n.� the taxpayer
Property Description in d� �-�-A-�� County
Taxing District (c;�n, Township):
OO�v'00860
Township
Parcel Number � or legal description shown on tax statement:
� . o5'E ���F /�- - 2 - ii . ��.5� �.
If buying Ofl contract: Owners . name ��ee s�moie 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:
��hereby certify the above
� �� G J�.1C
t is true, correct and complete.
�«�, �oa�e�s
County Township
idry. acaie ana uo wae
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 -
True Cash
Value
Land not exceeding 1(one) acre imm
surrountling residential improvements �1 ���j (�l /000
Other Land (2) —
Totai Land MAY 11 �°"� (s� / o 00
Residential Improvements (4) aS0 70
�� �up1T Garag (5)
Total (6) aSo 7 0
Other Improvements
T Improvements - Line (6) plus (7) equals (8)
Iti,�,eby certify the above is true. correct. and complete.
Signamre ol nssessor
Assessed
Valuation
�30
_.
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- - -•
(�) — �ii-1F
(8) � So 7 0 ��
- ACTION BY AUDITOR -
Da�c
Date:
Homestead
Valuation
�
• }INE fI1M V !!M�0.:1 vYl TRi'�hSI1RERlOR4'�SiIA
Gibson County Auditor
101 N Main
PRINCETON IN 47670
❑
1711
InJi.�iJuaL. mid ma,-�ieJ aouple are IimimJ �o ore homc.tc�J �andaN dedu.iion. A. �he rereipi ol thi� deduninn hromc�
mare beneficial, there is morc incrnti�x �han ewr far M1umes�ead frauJ. I Iomnttacl frauJ wusa highrr Iac bills for all; thereforr.
HEA I;1i-2009 requ'un uapa.crs who reccirc �M1e hanesicaJ standard dNuc�ion to .erilv ihat they are eli¢iNc w mcei.c the
benefi� ami to p�a'idr azWiiiunal identifyin_ in(umutwn Mcran� ro allw' counry ga'rmment ro M�mr mmitor IromeSrcaJ
�ilingc This inlnrmation x�ill M A� em�idenlial anJ �n nnly Lc arm��ed by aulMriinl rounry' ofGciols. Thr Ik�wnnmm of
I.vral Gmemmem Fieunc< eiil u+e Ihis informanon w erwte Iwin Out mill h:lp e�wnn� offirials diminit< humat<ad fnuJ.
• � � � � � —
Taxpa�•er Name Propertc Addre�s
� Helsley, Gary E/ Betty J
Gary E/ Betty J Helsley
510 W Poplar Ave
Princeton IN 47670-2360
�i�u��ni�i��n�n����inn�i�u��n��n��inn�����nn�n��
[���t I E Lw o o d
Address(num6erondstrecCCity,s[a[e,and�"LlYCUdc)—� — � ---
/D W. (�oplf+2 ��ve
Srcurily Numbcr (last 5 diciLS) Ihivers L
� �
j3 E T r'y I .� e,a n�
iilin� Address (Number and �vtt4 �Ip, slale, and "LIP calr)
��o w. �� /a�c A��. �c'.,�.e�-ro.v�
:ial Stturirv Number (lase 5 digiu) Drivers Licensr/S�ate ID Nwnber Qa
.�C:i�
State Parcel NumAer
26-11-12-400-000.860-027
J
.�lels
P O f3or 91
Printthon IN 37670
Leeal Descriptian
006-00860-00 PT SE � 12 2 11 .3756 AC
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,r �-7�� o
I ����y
� $ame ns p�openy:dJtess
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Each undersiened certifies, under penalty of perjury•, that the above and foregoing information is we and coazct and that he or she is eli4ible to
receive the homestead standard deduction on this property. Each undersigned al>o understands that, by claiming additional homestead deductions
unlawfully, he or she may bz liable for back taxes and substantial financial penalties.
Own<r 1 $i�ma4vc � Dam 'fd<phonc �
I/ <{..�3-�0 ���� �