HomeMy WebLinkAboutHomestead_Hensley (6)Gibsan County Auditor
101 N Main
PRINCETON IN 47670
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IndiriduaL anJ rtu;nN coupl� are limi�ed �o ore IromcueaJ uandaN Jnluc�ion. as �hz receip� ol �hu deduction bcconua
morc benenrial, tlrrc u morc incrnmr than e�er (or homrsteaA fraud Ilomottad fmud caa.� hict�er tn bills ior all: thertfore.
HE.\ G7-i-7(NW requim uipacen ��ho reccivc ihc hanes�ceJ standard dcJunion m rz'Nr tl�t �hcy art cliciMc m rccenr Iln
benefi� aml tu pnn�id< adelitioml identiirine infwma�iun necesvn� �o allw� counn� gaemmmi ro Y.ner mwi�w IwnxsrcaJ
filin��. This in(nmuiion will M Aery contiJrniinl and r.m nnly h� arenaf hy amlrorized roumr o(Tcialc'fhr IXpannrcnt nf
I.ucal Gmemmem FieuMe will ux this in(u�maiion ro�'rcnm 4uls tha� aill h:lp counK of5nals dimina�e trom<9eaJ traud.
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� �nceton I\ 47670
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State Parcel Number Leeal Descri�ltion
2611-10-300-000.854-027 �s-a085a-no PT NE SW 10 2 n 2 AC
— __.._ •_ _ .__D_17_. _. __ . _ __ . ' . _
Social Securily Number Qast 5 digits) Ihiver's Licensc/Suie ID Nmnbrr (last 5 digib) Oihe� (plcut specify in Part 4 bclow)
Spouu , First Middlc ' Lut
Mailing Address (Numbcr and Nee4 d�y, s�ale, nnd ZIP cuJe) � S:une as pmpeny address
- — Social Sccurip'.Numbcr,(lazt 5 dicics __ Driver's Liccnsc/Sta[c ID Nwnbcr (1azt 5 digi[s) Othcr (plrvsc spccify in Pan 4 bclow�)
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Each undersigned certifies, under penalty of �rjuq•, that the abovz and foregoing infonnatiun is we and coirect and tha[ he or sFie is zlieible to
receive the homeslead standard deduction on ihis property. Each undersiened also underslands thal, by claiming additional homestead deductions
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FOPM MC 10 1979
HescriGeE By State BoarG at 7a. CommissianerS
CLAIM fOR NOMESTEAD PROPERTY TAX CREOIT FOR YEAR 19�
io Be Fi1M in DuO����e
SEE BACK FOR
being claimed:
I, (We) ❑ owned ��- bo85y
❑ are buying under contract
❑ have a beneficial inte�rfeL/st in the taxpayer
Property Description in �"'�°"- Co�unt>y O�� "-' Township
Taxing District (GiFy. Fewn, Township): �"�z�
Parcel Number or legal description shown on tax statement:
�� •�1/ E��a SLCJ '�s� /o- z- i i a•¢
If buying Ofl contract Owners name ��ee simoie ownerl
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.
�!�.��urP � �, � sUeet Aatlress
�`'�'�e;/���i,�,wtia� 7 7�711
�w:y. aca:e ano uo �.oae
�l� vidal either owns �r is buying under a coniract 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 immedilte4y ���79
surrounding residential improvements ��N
Other Land
Total Land
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Residential Improvements p���R
Garage
Total
Other Improvements
T Improvements - Line (6) plus (7) equals (8)
I�by certify the above is true. correct. and complete.
$igfldtule ol ASSPSSOr
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(3) S G O
(4) / �Soo
(5) —
(6) / 8 f o 0
(�)
(g) / $ 8 a o
- ACTION BY AUDITOR -
Assessed
Valuation
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Homestead
Valuation
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Date: �—��