Homestead_Hensley (5)t RI�
d�- 4
� g CLAIM FOR HOMESTEAD PROPERTY TAX Fo
}��� CREDITISTANDARD DEDUCTION, HC�� � .
�.; ,� State Form Sa73 (F2 / 5-92) ,
` ;.�. � - 'kV�V 101993
INSTRUCTIONS: See reve�se side 7oi /iling insf�uctions.
=---�`-'-7 CERTIFICATION STATEMENT
�'"ve) _��}� _ I'P� P�"`� ._./ V���� - certity that on the 7 st day of March. 79�
_) occupied as our principal place of residence the followmg des ibed reaLproperty for which a Homestead Pmperty Tax Credit is hereby claimed:
I� I(We) owned ❑ Are buying under comraci
❑ Have a beneficial inierest in the emiry that is liable for the pmpeny taxes on the property and that owns the property or is buying under a contract.
� - - - CONTHACTRECORDED
It buyinq on contract, Pee Simple owner's name� . � ' . �� �
Recorder's oftice where contraa is rewrded Record number Page
County
PROPERTY DESCRIPTION
Taxing distritt (city, fown, township) .
Pl lb�6erb 0� 1�� Legaldesl Tn lv C� I`T— L—/' ` I.. D dJ /�.
It any ponion ot ihe res"Mential struaure or the larid no� exceedinq one (7) acre that immetliatety surrountls that struciure is used to produce income, desuibe the use and portion
of ihe pmperty ulilized to produce income. ,
� PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township Counry Township
�.�- . �—. . �—
certify the above sialements are true. correci and complete. � f'��'�' j"�'':
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
. VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately
surroundinq residential impmvemenis. (�) .
Oiher land (p� '
Total land (line 7 plus line � (3� '
Dwelling (4)
Fiesidential improvemenis
Garage (5)
Other improvements (6)
Total improvements (line 4 through lina � (7) - I
Total value (line 3 p�s line 7� (g)
I hereby Certity ihe above is �rue, cArreCi, and SignaWre of Assessor Date signed
complete. -
�'ying aaion - Sgnature of Audiror Date signed
�
79_Pay79_ I
Lesser of ll2 Homestead
�Valuation or 52.000 S
Signature o�
AILOWANCE
�.. _•._5,���
RtE5C9JBm BY TI IE OEP.UIiMEIT
GibsonCountyAuditor � � � � � � � � � � � 'i�i�iii
� 101 N. Main SUeet �ndividuals and rttartied muplcs are limi[ed m one humccread standard deduaioa As the receip[�of this deiluction 6ecomes
, Pnnceton, IN 47670 more heneficial, �hcrc is mare intcntivc tlwi cver fot homcslead (nud. Homes¢ad Gnud wa¢s highv Iax bills (or all; thcrcforc,
HF.A 1344-?009 rtyuires tupayrrs w1w rcccive thc homesicad standard deduction to �xrify tha[ �he( aze eligiblc to recen'c thc
� ����� benefil and to prtnide addioonal identifiing infomuuon necessar�� to sliw� counry grn�emmecl t<i bever moni[or hoaestead
filings. lltis infomution xill be kept wnfidrntial and can only be accessed by authoriied wunty afficials. The Depart.�nen: of
I.acal Gm�emment F�unce ai0 use d�is information to crtam taols �hat will help cowry officials elimiitate homestead fixud.
: �.� � • -
_ OCT 4 2011
_ . c.�.n`-8--,�-.,
_ , GIBSON COUNT AUDITOR
1867 ' -
Taxpaver Name Location Address
Hensley, Rick �
�
0 OFF 50 S
PRINCETON IN 47670
I
Rick Hensley II�I�IIIW�III II I�III �I�II �III�I�II�II��II�II�II�III�II IWI�I �� �II�II�I�I� II II
380 S Richland Creek Dr i
Pnnceton IN 47670-8173 '
i�PiI���I�II���I�i��I��iIIP�II���i����ii�r�i���rliilllll�lli� StateParcelNumber �eaalD�.s�,�pc�o�
26-11-14-200-000.831-027 PT NE 14 2 11 1.0237 AC D-1
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This form MUST be returned to County Auditor's office. I
Please do NOT send this form back with your tax payment to the county treasurer.
.�� �F��I r-
1 C �
ling Addcess (n�bcr and stree6 city. state, and ZIP code)
3S0 s iel�la �( C're�l� �r. `r�
al Security \�ber (last 5 digics) Drivels Liccusr/Statc m Y�rmber (
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� � �z�+ 6-er� I
Address (Number and sveet, ciry. state, and 7,IP code)
Numbcr Qast 5
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Drivcr's Liccnsc/State [D
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s aigia)
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Same as property addfess
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;�iow�
as properry address
Other (plea5e speci(y in Part 4I
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undersigned certifies, under penalty of pequry, that the above and foregoing information is we and correct and ihat h'� or she is eligible to
�e the homestead siandard deduction on this property. Each undersigned also understands that, by claiming additional fiomestead deducrion
; fully, he or she may be liable for back tazes and substantial £wancial penalties. j
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