Homestead_HensleyFOPA7 HL 10 1979
Prescri�eC By Slare Boara ol iax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 � y
lo Be Filed in Duolicate
SEE BACK FOR FILING INSTRUCTIONS
�(We)�/�-�-��+- �'9+-�- ��� � O� � certify that on the 1st day of
i
arCh, 19� I{W?) _r=iinia_ ag ni�r nrinr_.inal nlar_.g f rgeirla.n.r_.g the fnlln�,ying dOSCribed reel propefty fof
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned
O are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in ��-�°-'T� County
Taxing District (City-�ewrr, Township):
ParcelNumber or legal description shown on tax statement:���
n.l..SW��Y /S-.z -// l�'9)
po� - bo8ss
�
Township
If buying Ofl contract: Owners name ��� s�moie owneq
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.
v �%�'IL �=_`�
nature ' SU¢et AOdres y. Scale antl Zip CoGe
' 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.
ASSESSOR'S L1SE ONLY -
Land not exceeding 1(one) acre immediately
surrounding�residential improvements
Other Land � �
Total Land � � �
R' d t' I I t
True Cash
Value
(�) �Sco
(2) / 7 a �.._o
(3) / 7 S io
esi en ia mprovemen s Dwelling �a) �/ Sc
� � 2 �Ua�ge (sl 3 � o
�u� � s
T tai (6) `� � I o
Other Improvements '/����� (�) 7/ C c
Tr' Improvements - Line (6) plus�e Is (8) pU��T�R (8) /��� p i
I�by certify tl�e above is true. corr l. and complete. -�
SiSnawre oi Asseswr
- ACTION BY AUDITOR -
Assessed
Valuation
Da:e
- � -
t/J
Homestead
Valuation
/�e
Approved: ,c�����L��.C�! Date: l • x�-�,y
. �c. �
� Gibson County Auditor
101 N Main
PRINCETON IN 47670
•
1893
rwnsuacawxvi-in
InJividuals anJ marricJ tnuplc. a�c IimilN lo onc hnmeacaJ ,undanl AcJunion. As ihe rccrip� ni thi�.: dcJunion become�
morc brneficial, �hrrc i.. morc incentne dun aer for home 7ead GauJ. I Iomnteael fiaud caus� higher �ax bills for all: thereiae.
HEA 13i3-?fN)9 requim baparers who roccirc Ihc hanestead slandvd deJuc�ion ui verify �lu� �hcy arc diciNc �o rcceicc �h.
benefit aN to pnxidv :xlJitio�ul iJemikin_ Infurm:nwn nece.vn io allw' cwnn� gwrmment �o Ntm; muniror homrseaf
filin��.'ITi. inlnrmaiinn will hr Aryw mnfidcntinl anA r.m nnly h• acarcaxi by aWhori�nl rnunly nfTiciul�.'fhe Ihpannrem o!
lucal Guvemmrn� Pi(u�rce xill u.e this in(ovnation w create [uuls Out will h:lp cvun;y officul. dimmem M�mes�cad (raud.
� � � � � � —
Taxoaver Name Prooem• Address
Hensiey. Ps� il
3so s
Princeion I\ iJ670
Phyllis Gail Hensley
1324 S 350 W
Princeton IN 47670.8159
I�I��il���l�ll,�l���lll���l��l����ll�l�l�l�l����l�l�l��ll���ll
�h� II ��
¢ Add�bynumbcr m�d'atraY, city,
�ti
Smurit} Numbcr (las 5 die��s) Driver's License/S
;
�
Sccuriry Numbcr (lac� 5 digits) � DrivcYS Liccnsc/S�ntc ID
LeQal Description
OOCr00855-00 PT SW 75 2 11 3.671 AC
D-17
/ /G,�tJS /<
y p:aycf�r
spccif in Pan 4 bclow�)
� $�un<as p'openy add�as
spccify in Pan 4 bclow)
undersitmed certi6es, under penalty of �pury�, that the above and (oregoing infurmation is we and correct and that he or sh: is elicible to
+e �he homestead standard deduction on this propeny. Each undersiened al;o undersiands that, by claimine additional homes!ead deductions
��fully, he or she may be liable for back taxes and substantial financial penalties.
� 1 Si c Uat_ 7'clephonc
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