Homestead_McKannan I
.'f STATE FORM!DM.I R-I 5-1.1 TREASURER FORM TS-IA
APPROVED BY<TATE BOARD OF Mit RL\T<.Eon PRFYAIBm BY nil DEPARTMENT. OF UXAE C,MRRYMrM17 FINANCE IC♦EI--_J.1
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 user for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
iii HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to teethe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only h i accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
McKannan, Cullen W/Mary L
1002 F Emerson ST
Princeton IN 47670
1191
( ccer1 Mary L McKannan
1002 E Emerson ST State Parcel Number Legal Description
Princeton IN 47670-1934
1111111111111111'111111 1 111111111111111111 1 111 1 111 26-12-08-103-001.258-028 019-01258-00 S&R ADD 15 PT
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
a-/� ks u e, .' lie M,C-ch Gt n ham
�g Address(number and cruet.city,state,and ZIP code) D Same as property address
(I b 0i L . Crno .so4 6% 11-lttlE e• -0.0 LnJ 1-66,70
Spouse First Middle Last
Mailing Address(Number and street,city,state.and ZIP code) El Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
-_ _ -.. sus
PART 3:CERT FICATION - -
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 1 Signature Date
fit_
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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 5473 (R2 / S92)
INSTRUCTIONS: See �everse side (or �ling inshuctions.
FORM
HC10
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C TION STATEM T
I(We) t a n 7 t y f rch, 9_
I(We) a:cupied as our principal place of residence the following described real p perty for which a Homestead Property Tax re i e imed:
❑ I(We) owned ❑ Are buying under contract � - � NO V O 3 ZOOO
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the perty or is buyin under a contract.
- CONTRACTRECORDED�
If buying om m�Vaci, Fee Simple owners name
Recordefs oHice where conVact is recordetl Record number Page
- PROPERTY DESCRIPTION
Counry Township � Tarzing disMcl ("ry, ship)
Par el nu be=��� � D Legal description � J
S
It any.portion ol ihe residentiai sirucwre or the lantl rwt ezce�ng one (1) acre that immediatety sunountls Nat st cture is used m protluce income, describe ihe uu and portion of
the properry utllized to protluce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Coun Township Counry Township
Signature of claimant
,ereby certify the above statemenis are true, correct and complete.
Address (number and streeL ciry, sfate, ZIP cotle) -
- ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE - VALUE VALUE
Land not exceeding 1(one) acre immediately �� �
surrounding residential improvemenis.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4)
Residential improvements
Garage (5) .
Other improvements (6)
Total improvements (line 4 through line 6) (7)
7otal value (line 3 plus line 7) (8)
I hereby Certify the above is true, correct, and Signamre ot Assesor Date signed
complete.
Verifying action - Sgnamre of Auditor Date signetl
� STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead $
V luation or $2,000
Sgnat ot Oitor Date si n — `
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