Homestead_Kendall STATE FORM 5]U0(KM Eta) TREASURER FORM-IS-1A
—, APPROVED BE STATE BOARD OF ACCOU'TS.HW PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVER NMENT FINANCE IC 61.1-214.1
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 incentive than 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
0 FILED benefit Tanhd is tio n fporromvaidtie o n a ddwiiltl i obe na l k epide n
t ctiofnyifindg e nitno ma
and t icoan n necessary a ccto e saslelod w b y c oaunuthtyo rgizeovd e rnm
counenty t too fbociner s.Thmoe n iDtoer p homestead
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Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFOR.\IATION
APR 1 5 2011 Taxpayer Name Location Address
C ,� Kendall, Betty S
cr.d'1 504 S Main
GIBSON COUNTY AUDITOR ■c) Princeton IN 47670
/ -.4-C% — _III_ w iIIlomII_ I iII II I II.IIIohm/-1/..Ill 1 Betty'S Kendall 2.--i. 0-
504 S Main i
Princeton IN 47670-2446
I'III'I'I'lllIllliiiiII1'll' i ililIIIIlllll'll'llllll'1I1IIIIIili State Parcel Number Legal Description
i 26-12-07-304-003.600-028 WILLIAMS 1 PT
hortfizipit
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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.
PRT 2 -1-A P. . . • _• - _
ION _ _ _.� --_ - -.
.1 - A
I First Middle Last
Mailing Address(numberld street,city. Q state,and ZIP code) El Same as property address
3f ) Cat Je--An_ / At) . ) '1 5 /c n F1. 335 73
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
Social Security Number(last 5 digits) Drivels License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
1 1 , 1 1 1 1 1 sect
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 Signature Date
(( )
PART 4: ADDITIONAL INFORJIA"1'ION
FOPM HC 10 19i9
PrescriEea By Sta�e Boa�a af Tae Cammissfoners
io Be FileC in Duplicate
, _CLAIM FOR HOMESTEAD PROPERTY TAX CREDIT FOR YEAR 19�� �
SEE BACK FOR FILING INSTRUCTIONS ��9 - O,3 �pOO� Ot'7
�(We) ���°"�w ��" �-�-��• ��certify that on the 1st day of
March, 19a�, I, (We) occupied as our princip place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) L`lowned � � � a�
❑ are buying under contract ,
❑ have a beneficial inter t in the taxpayer
i
Property Description in C�unty �� Township
�7
Taxing District (City, Town, Township): �X
Parcel Number � � or legal description shown on tax state ent:
.vw . (�C.eC.d. �- l ,�-t� /o� z
If buying Ofl contract: Owners name ��� simD�e axneq ��
Contract recorded in Recorders Office - Record
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:
�hereby certify the above statement is true, correct and complete.
i�
� l�.�d t`s /ZiQi�i-�
5vee�
County
Township
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ana Lo �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 the taxpayer.
- FOR ASSESSOR'S USE ONLY
Land not exceeding 1(one) acre immediately
surrounding residenlial improvements
Other Lantl
Total Land � � � � �
Residential Improvements
,; UN �'- E 1979
Owelling
Garage
���~�-�d�c.o.tio ta I
Other Improvements � �
F�Improvements - Line (6) plus (7) 9t}i��jl€$)
I nereby certify the above is try� correct. and cq�plete.
Signawre ol nuessor
�T�����►
True Cash
Value
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(3) �
(4) /a2 ��a
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(6) �--tt'D
(7) —O—
(8J _�_ -�
UDITOR -
Assessed Homestead
Valuation - Valuation
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