Homestead_McEllhiney (3)•
1111TE FORM!_11,11.111:11-1101 TR£.iSLUQ FORM T3-IA
APPROVED NY STATE MVIDMNYnrI'r S.wu PRr3TIBED BY 1111 DEPARmc cOr tOCALr-0xtR.VMr1.'r FINANCE M F-I.I-r-.I
Gibson County Auditor 101 N Mein. IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCEI ON IN 47670 Individuals and married couple. are 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.
HEA 1344-2009 requires uxpaycrs who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will he kept cnntldentin,and can only he accessed by authorized comity officials.The Depannlent of
Local Government finance%sill use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ McEllhiney, James J
RI BOX 1211)
Francisco IN 47649
4459
James J McEllhiney
5670E 175 S State Parcel Number Legal Description
FRANCISCO IN 47649-9029
ItIuIIIIIIIIIIurrlrlIIIIIIIlItlIi I IlFlttlttrlll IIII 26-13-19-100-001.589-004 C-1 D-7 PT NW 19-2-91.792 AC
X
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
4.g Address(number and street.city,state,and ZIP code) --- — — — Same as property address -- ._
5(070 — E / S S Frcrncisoo Di L-17(099
.
Spouse First Middle Last
/ ‘US a 01Ci 1IA ; n -e
Mailing Address(Number and street,city,state.and ZIP code) 12' a as propeny address
S(0 5o f_ 1 7 5 S Tr_ con c. IS co _i_---ru y76Li9
•
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 gnature Date
CLAIM -FOR HOMESTEA j D PR . OPERTY I TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (R614-03)
Prescribed by the Department of Local Govemmem Finance
INSTRUC77ONS: See reverse side for riling instructions.
' YEAR
0 �
IT-1
JUL 0 8 2005
ce
;ence th�i/-Iloyiring described real p sit
(Iww:)) occu our �pnnclpal place f idenc �Itrh�f/ollowrlg �des/cnbed �realp rty �forwhich , �Hom( Homestead Z,o1p&erNtyt"T8( Credit is is hereby claimed:
07 pal la under act
I (Ne)�ecl, ❑ Pre ccentract
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
RECORDED
If buying on contract. Fee Simple owners name
Recorders office where, contract is recorded Record number Page
�-`f.*-iOROPERTY.'dWNE6'.f3y-cLojmANT,,IN'OTHER�cbUNTIESi,.�2�',�����--4i,�,�F'r YYt
County
Township
1p
Tewing district (city, town, township)
Parcel number
02'
I Legal �
Is the property In question:
cz -C/
❑ Real property ❑ Mobile Home (I.C. 6 -1.7 -n
If an portion of the residerIbal structure or the land not exceeding we (1) acre that t ty surrounds that structure is used to produce income, describe the use and portion
y
of the property utilized to produce Income.
CAK -. 12 - ILIJO - 0e)/
�-`f.*-iOROPERTY.'dWNE6'.f3y-cLojmANT,,IN'OTHER�cbUNTIESi,.�2�',�����--4i,�,�F'r YYt
County
Township
-7 HOMESTEAD4
Z�r �'
County —Ywv nship
I hereby certify the above statements are true, correct and complete.
S
Signature Getma It
d street, city, state, ZIP code)
W— (M!; ec, < ,13 -2 4 F-- --_, ;e :z:-A,)
It, ?,6 Yq
STANDARD, DEDUCTION'ALLowANCE
M',,VAL1JE0,*-C-
ASSESSEDAVALUE
�IAT 100%40F
-7 HOMESTEAD4
Z�r �'
nv'-ip.KNON-RESIDENTIAL7qt -zt
Valuation or 535,000
S
"TTV�
VALLIEVR
Land not exceeding 1 (one) arre immediately
� Vi
surrounding residential Improvements.
CfEm V11 R
Other land
(2)
Total land (tine I plus line 2)
(3)
Dwelling
(4)
Residential improvements or Annually
Assessed Mobile I Manufactured Home
Ga rage
1' -4- 1
(5)
K-Mo L
Ober improvements
(6)
=
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
STANDARD, DEDUCTION'ALLowANCE
20 Pay 20
Lesser of 112 Homestead
Valuation or 535,000
S
Signature ofAuditor
Date signed