Homestead_Carey MATE FORM.5t* R:1 f.01 TEANLER NAN 3-IA
M./ROVED BY STATEao1RO OF AffYatNIC, rVYslREm BY TIE DEPARTMENT OF LOCAL rst EELYMEKr FINANCE Mr-1"1r_-AI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD.PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than net for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires axpapero 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 emernment to better monitor homestead
filings.This information will he kept confidential and can only he accessed by authorized county officials-The 1lepartntent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
"- - — - - - "Carey, /Alice,F - - - - — -- --
IstSi' 4
Patoka IN 47666 Q
612
Alice F Carey
411 W 1st ST State Parcel Number Leal Description
Patoka IN 47666-9015
ItIttlltrrlllltrtlltttllttltlrtll 11.11Ittttlltttlltlttll 26-04-25-103-000.09 8-020 018- &
oDOS -0OCOLEMANENLG 1PT
%'
Spouse First Middle Last
AZz— C a 'rAyC CARE
Mailing Address(Number and street,city,state,and'LIP code) 13-Same as property address
'1/ i
LL) js,- sr 7°4r6 r R , ZI! 97666 •
'?
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 Si azure Date
PART 4:ADDITIONAL INFOIt\1ATION
•
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5173 (R614-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
I (We) 1/1J
following des cr a real property for which a Homet ftMRpgl&TaTyredtt is hereby claimed:
tract n1 lL OODU AUDITOR
Have a beneficial interest in the entity that is liable for the property !axes on the property and that owns the property or is buying under a contract.
�{.- s' -
W',r�iCONTR%iCT:'RECORDED��a ° �' r'` 6° A`�,'•.3"�'�,�',t'�ri "�- .t'�+c ^+.�PF?�l;'�`.,�".�'iT`tt
If buying on contract. Fee Simple owner's name
Recorders office where contract is recorded Record number Page
AMarEGYM` cye%'S' �re `n *.r`:sew'x�'mrRa'�w:'1 i✓.d P.ROP.ERTY:DESCRIPTI- x N-ia eRt :?, ! >+ 5,`-r;-. x'g`'v$G�ris, ,.,:. e }:'-, ,.u5t>
.r-
County
Township
County Township
Testing 5is Ury, townsh"
P cel n r t�/1
L d cdption
Is the pro in question:
- 0
"(' TRUEvi"i- xs
VALUE
at emu.
(1)
ASSESSED VALUE
/1Tc100 %'OFTTV.
_
Real property ❑ Mobile Homo (LC. 6 -1.1 -7)
If any potion of the residential structure or the land not exceeding one (1) acr
at immediately, surrounds that structure Is used to produce Income, describe the use and portion
of the property utilized to produce income.
Other land
y1yf.
'.,. _;- 4).(w"tr<?>3�..uP, ROP,ERTYOWNEU`,BY; CLAIMANT, IN: OTHERCOUNTIES ,Ar- r_'::?icr.......s._4z -rte
County
Township
County Township
I hereby certify the above statements are true, correct and complete.
Signature of claimant
Address (number and street, cdy, stare, ZIP code)
/ F- 12 A 6
ASSESSORUSE ONLYo-f
_ ss�3✓3,s..2e'a++ic•_ -.vdLl'�- ,'H�t�ii e,M:.... •7»'}.t
_. G
"(' TRUEvi"i- xs
VALUE
at emu.
(1)
ASSESSED VALUE
/1Tc100 %'OFTTV.
_
NOMESTEAD c
z?7VAI.UE` ""'g"L'f�!VALUE�'
�,.- -1, �V
;��ar, NON RESfDENTUIL
`may'
�
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
[7r S
1
Other land
(2)
Total land (line 1 plus line 2)
(3)
'Residential Improvements or Annualty
Assessed Mobile / Manufactured Home
Dwelling
Garage
(4)
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(T)
Total value (line 3 plus line 7)
(8)
hereby certify the above is We, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
- - '.'�`- �a�.'rr�"�t�r�ua0��ru�; STANDARD'. DEDUCTIONiALL' OWAIJCEE;:;; �,;, �'y �', n, �frq" cyx' �, �t� ;�r%�.- i[C1�°,,,�;i�.i�qu'1•_.
20_Pay 20_
Lesser of 1/2 Homestead 5
Valuation or 535.000 -
Signature of Auditor Date signed