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Home My WebLink AboutHomestead_Helsley FORM HC 10 1919 To Be Filed in Duplicate Prescribed By Slate Board of Tax Commissioners CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19 7,9 SEE BACK FOR FILING INSTRUCT-IONS • ® (We) (friciin 3.L _�tify that on the 1st day of March, 19 7 y, I, (We) occupied as our principal plac f residence the fol ing described real property for which a Homestead Property Tax Credit is hereby being..claimed: I, (We) ❑ owned ❑ are buying under contract ❑ have a beneficial inter st in the taxpayer Q` . Property Description in �1�C1 �—d �J unty -�+/�.,ssc.J Township • Taxing District (City, Town, Township): Parcel Number or legal description shown on tax statement: S l .26474 g/l9 If buying on contract: Owners name Pee simple 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: County Township sphereby certify the above statement is true, correct and complete. 1 a.ur Street Andress City. State and Zip Code S A0l7q • 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 Assessed Homestead g f on Value Valuation valuation Land not ex di 1 (one r: ediately A9° surrounding ti r •1 . (1) grail 'O 290 Other Land (2) — 0 -- 0 — o MAY 221979 (3) 130 Total Land Residentipr r m tom (4) i /s �� . 'v�11 Dwelling !��ns v y�� AUDITOR Garage (5) / 0 // > = :C : j -° Total (6) 'S V!o Other Improvements (7) /-3 o JlJJ T Improvements - Line (6) plus (7) equals (8) (8) —1-1/979- eby certi�y/y1�the above is tr e. correct. and complete. S4e77 Ao 4430 dS7o "- Signature of Assess `- `cam Date - ACTION BY AUDITOR - Approved: ai Date . - _ _ STATE FORM 535.4(R)1610) TREASURER FORM 154A APPROVED BY STATE BOARD OF ACCOUNTS F4 PRF.SCRIBU BY TilEDFP.ARONE.T OF LOCALCOVFR.'MENT FINANCE IC 1.1.1-21-11.1 Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS '101 N. Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes Princeton, IN 47670 more beneficial,there is more than incentive th ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore, • HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the benefit and to provide additional identifying information necessary, to allow county government to better monitor homestead I L E D ry filings'Dus information will be kept confidential and can only be accessed by authorized county officials.The Depareneni of Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud. PART I: PROPERTY INFORMATION APR 8 2011 Taxpayer Name Location Address C-'J.rn Hensley, William R/Retta J v `v\ 505 WASHINGTON ST GIBSON COUNTY AUDITOR SOMERVILLE IN 47683 2813 fp f[ William Robert Hensley IIII�III_Tc IIIIIQIIII-RI DIIDIIDIII iiI miry._IIIIIII DIiiIIiil GIIDII_IIIIC III do Recta Jean PO 263 Somerville IN 47683-0263 fill"'III"liiiii"" ' 'II111il i1liillilrlllrlllllltrllrllllrl State Parcel Number / Legal Description 26-20-02-401-000.144-003 / BARRETTS ADD 26/27/28/29 This form MUST be returned to County Auditor's office. Please do NOT send this form back with your tax payment to the county treasurer. r '1 PART 2: TAXPAYER INFORMATION ... Ov. I First Middle `� ' Last Mailing Address(number and street city,state,and ZIP code)/ Same as property ad ss Hati Spouse First - Middle Last —Mailing address(Number and sneer,city,stare,and ZIP-cider ---- . .--I u-Same as property address--- Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below) I I I I I I I I . I Sine PART 3:CERTIFICATION Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or she is eligible to receive the homestead standard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions unlawfully,he or she may be liable for back taxes and substantial financial penalties. own i I Signature Date dbif F ii Signauree t" " v Cy P 1441 Date Telephone ( ) PART 4: ADDITIONAL INFORMATION