Homestead_KeyCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
Shft Form 5473 (R71 54M
Prascribed by eve Depertrrwd of Local Governmerd Fi
INSTRUCTIONS., See reverse side for filing Instructions.
TO
F 6Dn
I (we) -f- - - car* that on the I st day of March, 20—
. as our principal piece of residence, the following d real property for which a Homestead claimed:
(We) ❑ Are buymg under contract a
: PF GIBBON COUNTY AUDITOR
j Have a beneficial interest in the entity that is liable for the prop" taxes on the property and that owns the property or is buying under a contract.
IV
ff buyng or, contract, Fee Strnple owners name
Fbxm"kes arme Where contract is raoordad Record number Page
PROPERTY DESCRAMONe
County
Canty
Towishp
County
Township
narber
21
Is the pop" in question:
I Rail property ❑ MOMI. Hor. (I.C. &1.1 -7)
If arty portion of the restderdist mrrchae a the land n�12,, (1 ) acre a W &99 a m used b produce income. deembe the we and portion
afth prop"LAj1wdtopro&xe�.
7)Z� I-'Z- a4 - 0 6-1a 17-1-- AV - CCO
�3 "phopoft*'OWMM 13*,CLAUAMT[k OTHER CdtjkjlESJ'h
County
To�mstdp
_1-1011IFSTEAD'
County
Township
I hereby certify the above statements are true. coned WW complete.
®test (rhinos end meet :,Ir JPI code)
Q
ASSESSOR USE ONLY
TFttJ V;
- w E,TAX
ASSESSEI
_1-1011IFSTEAD'
Land not e)xeedng I (one) acre unnedistall?
stinuunding residential improvements.
(1)
Other land
(2)
Total land (lire 1 john fm 2)
(3)
Dwelli
'W
Readertbal improvements or Annually
ng
(4)
'-I'�'z
Garage
5�a Z,j 'N't
Assessed Mobile I Manulaclixed Home
Other improvements
(6)
Total improverthertts (Eire 4 through Iino 6)
(7)
Rini value (fine 3 pus fine 7)
(8)
I hereby certify the above is true, coned,
sl� of A�
Date SV*d
complete-
Varrtying ac ran - SigrmWre of&dtor
Date Wwwd
:?'STANDARD DEDIXTHWALLOWANCE,
20_ Pay 2O_
Lesser of 12 Homestead
Valuation or 535.000
Signature of Audits
Date signed
STATE FORM 539.0W WM UREASUAER FORM 5.!A
.APPROVED BY STATE BOVtD OFACCYWJNTS:m+ PArgNBFD BY fir DEPARTNEYT OF LOCAL GovueMrKr FINANCE IC T.1-22-1.1 S
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 ester for homestead fraud.Homestead fraud causes higher in bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recene the
benefit and to provide additional identifying infornunon necessary to allow county government to better monitor homestead
filing.This information will be kept confidential and on only be accessed by authorized comity officials.The Depanment 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
Key, James D Trust
soo none
Owensville IN 47665
513
James D Key Trust
4375 N Old Hwy US 41 State Parcel Number Legal Description
PATOKA IN 47666
26-04-24-100-000.671-018 010-00671-00 PT N 24-1-11 180.25 AC
C-1
x
• PART 2:TAXPAYER INFORMATION .
Owner I First Middle last
1
•tg A d d r e s s(number and s t r e e t,city,state,and ZIP code)-- - - — 0 Same us prupe i ddies. - —--' -- - — -
�31s P O /i frG.,,(Aj 44 �-k0k._=U --76G
Spouse First Middle Last
----PAAA11> Sae Ke-N
Mailing Address(Number and street,city,state,and ZIP code) 0 Same as property ess
T
437cIJ vld I 14I U ' L- - -,4.) .-tic ‘c,
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 ^ _ f Date
•
PART 4:ADDITIONAL INFORMATION