Homestead_Kolb°• • CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
. :. ...y CREDIT STANDARD DEDUCTION I
State Form 5473 (R2/1 -90)
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT
I .
(We)/ certify that on the 1 st day f March , 19 L
I (We) occupied as our principal place of residence the following described real property f ILRet
Property Tax Credit is hereby claimed: I (We) owned El Are uyi
❑ Have a beneficial interest in the entity that is li ble for the property taxes on the property! Arad ttat the
property or is buying it under a contract.
s
CONTRACT RECORDED _ AUDITOR
If buying on contract, Fee Simple Owner's Name
Recorder's office where contract is recorded Record Number Page
PROPERTY DESCRIPTION
Count hip — Taxing District (City, town, township)
lz6o-eA I.
Parcel Number Legal Description
_ p t
If any portion of the residential structure or the land not exceeding one (1) allre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
-3a9= a6 o�_060_-9 19 -0 1 f
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON -RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Other land
Total land - line (1) plus line (2)
Residential improvements - Dwelling
Garage
Other improvements
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
(1)
1991 Pay 1992
Lesser of 112 Homestead
Valuation or $1,500
19 — Pay 19—
Lesser of 1/2 Homestead
Valuation or $1,500
(2)
Signature of Auditor
(3)
(4) - - -
- -
(5)
(6)
(7)
(8)
1 hereby certify the above is true,
correct, and complete
Signature of Assesor
Date Signed
Verifying Action - Signature of Auditor
Date Signed
STANDARD DEDUCTION ALLOWANCE
• 1989 Pay 1990
Lesser of 1/2 Homestead
Valuation or $2,500
1990 Pay 1991
Lesser of 112 Homestead
Valuation or $2.000
1991 Pay 1992
Lesser of 112 Homestead
Valuation or $1,500
19 — Pay 19—
Lesser of 1/2 Homestead
Valuation or $1,500
Signature of Auditor
Date Signed
IIAIE 1ORSI•!!M IM::•'NI T ESSUUlt W0.V IS IA
APPtwEO BY MIL BOARD Of YYYatS'lx.gw rtrstam By ter otPMh6.vr OF LOC.L rMetMMrwr FDA'CFIC4-I.I-r-1.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS •PRINCETON IN 47670 Individuals and married couples arc limited to one homestead aandanl deduction.As the receipt of this deduction becomes
more beneficial.there is more ingenue than ncr for homestead fraud,homestead fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to receive the
benefit and to provide additional identifying infomulnon necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only ts.accessed by authorized county officials.The Depanntent of
Local Government Finance will use this information to create trots that will help county officials eliminate homestead fraud.
. PART 1: PROPERTY INFORMATION
Taxpayer Name Prnperts'Address
Kolb, Keith H/Patricia A 954"
9541 N 1.rI pP• l't
0'
Patoka IN 47666
877
Keith H/Patricia A Kolb
4547 N Trippett Rd State Parcel Number Legal Description
Patoka IN 47666-9170
26-05-38-002-000.819-018 010-oo19-oo PT SUR 2 8 31 10 30.28 AC
181111111.11111e11111111111111 tau III ut III oI n I I oI n IIt I
i D-12 C-1
PART 2:TAXPAYER INFORMATION
Owner I , t First Middle Last fS
�187sddrea4(number und;tree,city,state,and ZIP code) - -'' r I t yautme as prupejjn''/r//ffuh�d/�1r�w11(- - (/`— --- -- --
S First Middle Last
/1--r-k l .L_ 1 ± A K L 6
Mailing Address(Number and street,city.state,and ZIP code) 0,Sanm as property address
S"cG7 M/Pee,-7- >2 b --ra AI r K1 4 -76 4 4
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 Signal J ca Date
PART 4:ADDITIONAL INFORMATION
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