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Homestead_Hensley (7)- ODI�-b115►._ ,�- d�..�r< �• CLAIM FOR HOMESTEAD PROPERTY TAX _ Fo _ � i. _' ^ 4 ° y; CREDIT/STANDARD DEDUCTION . Hci �`�� J :� State Form 5473 (R2/1-90) ' �'°�• �. INSTRUCTIONS: See �everse side lor filing instructions. M��Y 10-1991 . CERTIFICATION STATEMENT � (WB) 9� . (� � . .. . '� .r "' 'Ti� •• II (We) occupied as our principal place of residence th following described real property for which a Homestead Property Tax Credit is hereby claimed: I(We) owned ❑ Are buying under contract � Have a beneficial interest in the entity that is lia le for the property taxes on the property and that owns the property or is buying it uncler a contract. CONTRACT.RECORDED on contract. Fee Simple Owner's Name Recorder's office where contract is recorded PROPERTY DESCRIPTION town, Number � Page If any portion oi the residential structure or the lar(� not exceedi(i,� one (7 ) acre that immediately surrounds that struc- ture is used to produce income describe the use and portion of the property utilized to produce income. ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VA�UE HOMESTEAD VALUE NON-RESIDENTIAL VALUE Land not exceeding 1(one) acre immediatety � surrounding residential improvements (�) Otherland (2) Total land - line (7) plus line (2) � (3) Residential improvemenis Dwelling (4} - Garage (5) Other improvements (6) Total improvements - line (4) ihrough line (6) (7) Total value - line (3) plus line (7) (8) I hereby certify the above is true, Signature of Assesor Date Signed correct, and complete Verifying Action - Signature of Auditor Date Signed 1989 Pay 1990 Lesser of 7/2 Homestead Valuation or $2,500 STANDARD DEDUCTION ALLOWANCE 1990 Pay 1991 1991 Pay 1992 19 — Pay 19 — Lesser of 1/2 Homestead Lesser of 7/2 Homestead Lesser of 1/2 Homestead Valuation or �2.000 Valuation or �1,500 Valuation or $1,500 Signature of Auditor /] ' I\ � I ��e��D � .�/N n� � � ,f ll / `7 Gibson County Auditor 101 N Main PRINCETON IN 47670 , • 1110 .� � �-��� 0 {GR f0R\I lRE4l1RLRi0R41.1n InJividuals and nu:ried couplo arc IimitN m nrc hnmeucad �ufMa�d JNu.�ion. As the rereipt oi �hi; deduc�ion bttonrcs mure benencial, thrre is more incenme th�n ncr ior homcstea�l fnud I lomn�eyl fratal cau� higher �a� hills tor all; ihertfore. HEA 13ii-3IXW requires u�paren x�ho reccive ihc hwneseeaJ standarJ JNuction m.eriPo �lut thry am cliciNe io mcene ihc brnefii an1 to pnw'iJe mWitional iJenliirinc infumiatwn nem'vry �o alluu� counn� gcnemment to bcuer muniror humeste:W (linc.. ILis in(nrma�ion will br {.tiM mnfideniial anA rvn only 6e ucecuJ b�� aulho�iurl coum}� n(Ticials.'I'he Ihpanmrn� of lucal Gm<rmmcm FivMC ��ill u�c �his inio�ma[iun m crratt 0.ds �hat will h:In cwnn' offirials diminvc IromcstcaJ fraud. Robert S/ Marcia K Hensley 2665 W 50 S PrincetonlN 47670-8126 �i�i���ni�i��ii�in����i��ii��������������������n��i���i��i� Tnsparer Name Hensley, RobeR S/ Marcia K c S[ate Parcel Number 2611-15202-001.151-027 V � Leaal Descrintion 006-01151-00 SANDY RIDGE EST SEC A tOPT � ¢r I Firsl M1fiddle Ros�T s. �dENs�y '�e AdUress (num6cr m�d svee[, city. smte. ana ZIP code) '--'. "�..Sume m propeny m1J+�as-- -"— ,66S1.v Sa S 2.�NCE N !J �7b70 M,��,� I K I �S� 3ilinc Address (NUmbcr and Ntt4 cil)', slale, and "LIP cale) � S�une as pmpeny adJ+es, Z b b S w s'� S �2 � N�e�-oo� ,�t� �-/7s 7 0 Each undersigned certifies, under penalty of peryury�, that the abo�•e and foregoing infurmation is we and correct and that he or she is elieible to receive the homestead standard deduction on this propeny. Each undersiened al>o undersiands tha� by claiming additional homestead deductions unlawfully, he or she may be liable for 6ack �a�ces and subs�antial financial penalties. � /°��o �