Homestead_Helfert AWE FORM LJAMOC/W1 TRIALSuxnR FORM TI-IA
.APPROVED DV AERIE ROAR n OF ACT RATA 9M PRFYFIam nY PI-DEPARTMENT(/'LOCAL GOVERNMENT FINANCE IC 4I.1r'a'
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than nee for homestead fraud.Homestead fraud causes higher tae bills for all:therefore.
HEA 1344-200n requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information leceoan-to allow county government to better monitor homestead
filings.This information will he kept confidential and can only be accessed by authorized county officials.The Depanntenr of
Local Government Finance will use this information to create cools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Helfert, Jeffrey M/Terri L
RI Box 481
_ Fort Branch IN 47648
3338
Jeffrey M/Tern L Helfert
R1 Box 481 State Parcel Number Legal Description
Fort Branch IN 47648-8152
I tlttlltttlliltttlttlittltlttlttttlltlt ltt dr llllrltltt ltllt ll 26-22-09-100-000.287-024 004-00287-00 PT NW 9411 1.02 AC
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.
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Se-cc(e 01 /eI-Per1L
. erg Address(number d street city,state,and ZIP code) ❑ Same as property address
3991 td. S. R. 68 / 4 r2211eA , ). y'J,,y8
Spouse First Middle • Last
—Teri L Ock :use \-k�\-F' 'es-1-
Mailing Address(Number and street,city.state,and ZIP code) El Same as property address
399q- w . s.ie- 6,$ , /r+ era'nc/1 d.,ana %ZVI
' '
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.
Owner I i ature Date
•
d�^°�°� CLAIM FOR HOMESTEAD PROPERTY TAX vEAR
iE�:� CREDIT/STANDARD DEDUCTION �io�
�.,���. Stare Form Sa73 (R2 / 5-92) -
,.�� - r�� 0 91994 � 9�
INSTRUCTIONS: See ieverse side Ior filing instructions. ..
� " � ' CERTIFICATION STATEMENT " ' �
'��'"�e) - � certify that on ihe 75AUD��OR 19�
�) occu i ur p ncipai place of reside e the following described real property for which a Homestead Property Ta�c Credit is hereby Gaimed:
I(We) owned ❑ Are buying under contract , ,
Have a beneficial interest in the entity that is liable for the pmperty taxes on the property and ihat owns the property or is buying under a contract.
�� �� - . CONTRACTRECORDED � - -
It buyirg on contrad, Fee Simple owner's name . - . . - ' '
Rewrder's office where comrac� is recorded Remrtl number Page
ParCel
�-r' o�a
11 any portion of the resid
ol the propeny utilized to
Legal tles ri li
1 �
simaure or the land not excei
ice income.
��_,?�_�9_
PROPEHTY DESCRIPTION
town,
� Nt�.J �-y��l ►.a�-��
one (7) acre that immetliately surrountls that struciure is used ro produce i�ome. describe Ihe use arW portion
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON•RESIDENTIAL
VALUE VALUE VALUE VALUE
Land not exceeding 7(one) acre immediately
surrounding residential improvements. (�)
Oiherland (p)
Total land (line 1 plus line � (3)
Dwelling (4) _
Residential impmvemenis
Garage (5)
Other improvements (6)
Total improvemenis (line 4 Ihrough lina � �7) I
Total value (line 3 p�s line � (g) I
I hereby certity lhe above is Irue, CorreCt, and Signamre of Assessor Date signetl
complete.
mg action - Sgnature ot Audi;or Date signed
79_Pay19_
Lesser of 1l2 Homestead
Valuation or 52.000
Signature otAutlimr
STANDARD DEDUCTION AILOWANCE
S
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