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Homestead_Helfrich STATE FORM:9:141.1C/>APO TREASURER FOAM TS-IA ArrtwEn BY STATE Bn\RD Of ACrra:T2.94 PRftBW BY Mr BFPARTh NTOF LOCAL GOVEEAW.m--T lEANER MI-1.1'--r.1 Gibson County Auditor 101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes more beneficial,there is more incentive than ever for homestead fraud homestead fraud causes higher tax bills for all;therefore. ILEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are clicide to recewe the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filings. this information will be kept centennial and can only he accessed by authorized county officials.The Department of Local Government Finance will use this information to create tools that will help count'officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Prnpertv Address Helfrich Irma JTrust /a1174.4.n' /0005 4H-Box-5&- Haubstadt IN 47639 476 �f Irma J Helfrich 1246 W 1000 S State Parcel Number Legal Description - Haubstadt !N 47639-8605 III uI I I I I I I I I I I I I III III 26-18-36-100-001.831-024 004-01831-00 PT W NW 36 3 11 1.05 AC u F rut nn tFuiln n im tiennt nut v 0-27 PART 2:TAXPAYER INFORMATION Owner I First Middle Last /RM4 JE44( f/,a .LFR la A/ flag Address(number and street,city,state.and ZIP code) -- Same as propeny uddnss - - - /a 6lo ly /000,5 /794 Fv /no 5 Spouse First' Middle Last Mailing Address(Number and stmt,city,state,and ZIP code) 0 Same as property address Social Security Number(last 5 digits) Drisefs License/State ID Number (last 5 digits) Other(please specify in Part 4 below) 5= 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. Owner I ignature Date ' • • FORM MC 10 1979 PreSCriUeO By State Boa�tl al 7a. Cammissioners To Be Filed in OuD��cate CLAIM FOR HOMESTEAD PROPERTY TAX CREUIT FOR YEAR 19� � I�, 3 I_� SEE BACK FOR FILING INSTRUCTIONS B/( // %��c., �Cd.�.�.-a.� e� �P. �.. ��„�.�. ci y�-� � I, (We) �ertify that on the 1st day of �'arch, 19 v I, e) occupied as our principal place of residence th following described real property for iich a Homestead Property Tax Credit is hereby 6eing claimed: I, (We) ❑ owned �"� /�— ry��p �� — !/d� �ol� �� ❑ are buying under contract ❑ have a beneficial intere t in the taxpayer Property Description, in ��'-Q-^J County Taxing District (City, Town, Township): Township Parcel Number or legal descr�ion shown on tax statement _�� i✓cu �� o5'w��K 3�-3-�� ,Ao,4e. If buying on contract Owners name �� slmple Contract recorded in Recorders Office - Record No 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: I hereby certify the above statement is true, correct and complete. �'_ ��„� sttrei noaress County Township ury. ata�e ana ti0 �e 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 ihe taxpayer. FOR ASSESSOR'S USE ONLY - Land not exceeding 1(one) acre immediately surrounding residential improvements Other Land Total Land Residential Improvements - Dwelling Garage Total Other Improvements Total Improvements - Line (6) plus (7) equals (8) I hereby certify the above is true. correct. and complete. Signa:ure ol A55essor True Cash Value (�) 500 �p� � 3 0 �3� 'f 30 (4) a S �f 7 0 (5) (6) a J �-F 7 0 (�1 (g� aS� 70 - ACTION BY AUDITOR - Assessed Valuation . _ � � . jj/�j�j/�� jj��j�/ i -� � Da:e Approved: Date: Homesiead Valuation i7o �