HomeMy WebLinkAboutHomestead_Kolb (5) SIME r ORM!1w in/34.01 TREASURER ORM TS-IA
.APPROVED BY ATATE MMPO Of arrOUS'l C.nry YEEYRIBED BY THE DEEMrxaan(F LOCAL GOVERNMEICI FINANCE IC LI.t"-r.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individual and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than eser for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
HEA 1344-3009 requires taxpayers who reeei'e the homestead standard deduction to verify that they are eligible to recehc the
benefit and to provide additional identifying information necesan'to allow county government to better monitor homestead
tiling..This information will he kept confidential and can only he accessed by authorized county officials.The Depannent of
Local Government Finance mill use this information to create tools that will help county officials eliminate homestead fraud.
PART 1:PROPERTY INFORMATION
Taxpayer Name Property Address
Kolb, Willard J/Carolyn Jean Trust
118 Olive DR
Princeton IN 47670
3994
Willard J/Carolyn Jean Kolb
118 Olive DR State Parcel Number Levi Description
Princeton IN 47670-3454
Ir lrtlltttlrlltrl ter 111 Iltrl ttltlt It tltrltt tllltrlt ttulll 26-12-18-403-001.510-028 019-01510-00 ROSS PLACE
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PART!:TAXPAYER INFORMATION
Owner I First Middle Last
_ i % p Jv1 I9 ,v /YD � ib
-altg Address(number and street.city,state,,hard/et code) /s/� /r' /. I I Sameee as property address /..� -- -- - --
l / U V e`; vim /! , /e�� i,//11 /V en 7--(941 f/Yr / b 70 - J '/ /
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) LI 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)
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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
•
FOFM HC 10 7979
P�escri�e0 By State BaarE ol ia. Commissfoners
io Be Filea in DuDlicaie
CLAIM FOR HOMESTEAD PROPERTY TAX� CREOIT FOR YEAR 192�L �/
SEE BACK FOR FILING INSTRUCTIONS Or(1 — Q�Sr�— OO
�(We) �� certify that on the 1st day of
arch, 19��, I, (We) occupied as our principal lace of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) C3�owned �
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in � County ���N Township
Taxing District (City, Town, Township): ��1�- u�-�--��;�- a
Parcel Number or legal description shown on tax statement:
`�P�aa �.L.a,c.e� (o
If buying on contract: Owners name ��ee s�mo�e o.�en
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: County Township
�hereby certify the above statement is true, correct and complete.
' 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 exc in 1(o ) ac m ately
surrounding sider�al ir�rov n nt
Other Land
Total Land (�p,}1}' 2 19?9
Residen[ial Improvements
� � /����=''diCRii!
� AUDITOR
Other Improvements
Dwelling
Garage
Total
T�Improvements - Line (6) plus (7) equals (8)
I.._ ..�y certify the above is true. correct. and complete.
A552550�
True Cash
Value
��� �—
(2) �
Assessed
Valuation
(c 3 a
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- ACTION BY AUDITOR -
s—ai—�s
oa:e
Homestead
Valuation
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Approved: /� •� � � Date: ' "� � �9 � 9
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