Homestead_FeagleyCLAIM FOR HOMESTEAD PROPERTY TAX YEAR
() 31 R n
CREDIT /STANDARD DEDUCTION lf!HC10
Scale Foon 5473 (R715-M 09
Prescribed by Do Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) v /T 'r r. Z �L at that on the 1st day of March, 20-
I (We) occupied as oua principal place of Qt� the 100,wingAescirgod real pirch" I a Homestead Property Tax Crectit is hereby claimed:
I (We) owned ❑ Are buying under contract 70
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-
COKTRACTJtECORDEDt;ue�:"
u?";U
If buying on oontracL Fee Simple ownees name
Pacarder's office where coritrad is recorded fiecrrd number Page
:*... .
. ,, —r:,',1;1' PROPERTY nC*.,
DESCRIPTION".
- ------ lia
Courity
Township
T i d . (CiIJK 10101. township)
sv-rf claimant
Parcel number
Legal description .1-00rlc- Lathe
1
Nmw (nmiber arid straelt city da e. co""
5--�S;57 L. 5'9 /
0 kror-A od 4-71itAt,
&Q Nopety
L06 719;7P7r-7r
❑Mobile Home (I.C. 61.1 -7)
If 4rry portion of the residential struchire or the land not exceeding one (1) acre dud irnmedialety anniunde; that struabre is used to Miduce income, describe the use and portion
Woparty W&md to Mod" income.
Land not exceeding 1 (one) acre, immediately
Date Soled
d'90-0/
PROPerr OWNECiBYCLADAMTtN'OTitEitCOLWTIES,r--'I
County
Township
County
Township
I hereby certify the above statements are true, correct and complete.
sv-rf claimant
1
Nmw (nmiber arid straelt city da e. co""
5--�S;57 L. 5'9 /
0 kror-A od 4-71itAt,
o�k A, '�,,
b
TRUE AX
ASS6SSEWWg
HOMESTEAD.
%sVK0N 4WSlDEN71l'W z
M USE y �, -�,r
N
4 -7
--'.T.
.
NSAQL6E- �"
Sv'sure of Auditor
Land not exceeding 1 (one) acre, immediately
Date Soled
't
av
surrounding residential improvements.
(1)
Other land
(2)
Tidal land (lone 1 phis line 2)
(3)
Dwelli ng
4
()
Res klential improvements cir Annually
Assessed Mobile Manufactured Home
Garage
(5)
Other improvements
(6)
Total irnpruvierneirds (line 4 through fire 6)
(T)
Total value (fine 3 plus fire 7)
(8)
1 hereby car* the above is true, correct, and
comPlete.
Silpeture, of Assessor
Date signed
Venlyft action - Signature of Auditor
Data signed
• �1,,% —',',STMDAM DEDUCTION ALLOWANCE,
W Ie
�-A 1- "' k
20_Pay2O_
Lasser of 12 Homestead
$
Valuation or $35.000
Sv'sure of Auditor
Date Soled
--?
start rots !M,0._/).MI TRf-ASUIIR rORM TS-IA
srrR[n'ED BY ST ATE Wssst)DP ACT YtL\it,1.v Par]YFIBED BY THE DEPARTMENT Of LOCAL r tNso TFINANCEe4E1-r-tI
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
+ 101 N Main
1 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 ener for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HPA 134-1-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying. information necessary to allow county government to better monitor homestead
filings.This information will he kept cYmfdental and can only be accessed by authorized county officials.The Department of
Local Government Finance Hill use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
_ Taxpayer Name Property Address
Feagley, Keith A/Jenny J
7
2759 W 450 N
PATOKA IN 47666
926
Keith A Feagley .
5389E 590 N State Parcel Number Lesal Description
PATOKA IN 47666-9173
M 1 1 1 1 1 1 1 1 1 1 1 I I _I I I III 1tit tat t t ttttt tit at 11 a I tt Ir It I tit 1tt 11 26-05-49-400-003.290-017 009-00487-00 PT LOC 125 1-10 2.001 AC
C-1
9 ,
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
111-N RGi-in] rEA4-LE Y
L
g AAdrcas(number and street, y,state,and ZIP code) — --- -"-® Same us pruperty adds - - - - -—
5359 E. Selo Al. 11TvR4) "TN• 41765to6,
,
Spouse First Middle Last
SEI•4M Y So 1FEeA&LE `2
Mailing Address(Number and street-city,state,and ZIP code) a Same as property address
5389 E. 590 IJt 9170VA) IN• •
-
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 Signa 4. 1-av� o Date t/ze/zo/Z
PART 4: ADDITIONAL INFORMATION
DEC GO 2012-
GIDCON COUNTY AUDITOR