Homestead_Channell .
%LAIC FORM'3.*If/'/fwl TIW SUILR FORM L}IA
APrMw'En BY SIAM&ARD°.Arml,N7A.!nr PLEXTIBm BY 111E BEPARnnn.YTOr LrRAI tAStLS'Mn.'r FB::NCE M41.1-r4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 - Individuals and married couples ate limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fraud.Iluomtead fraud causes higher tax bills for all:therefore.
• HEA 1344--3009 requites taxpayers who receive the homestead standard deduction to verify that they am eligible to receive the
benefit and to provide additional identifying information necessary to allow county goverment to better monitor homestead
tiiling>.This information will he kept confidential and on only be accessed by authorized county officials.'fhe Department of
Local Government Finance will we this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name . Property Address
'Channell, Kimberly D
• 405 S Main
• Fort Branch IN 47648
7018
Kimberly D Channell
405 S Main State Parcel Number Legal Description
FORT BRANCH IN 47648-1513
ItItrlltl tltllttt'ttllt tlttt tl1 •alt tt tlltt ll tllirtrltltt.•tt' 26-18-24-202-000.518-026 011-00518-00 MCCRARY ETAL 84 PT
•
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
imber/y V Ctiannell - Ha5c ssokJ
song Address(number and street,city,state.and ZIP code) - - - - - - ---• a Same as property address - - - --
Yoc S Main , F/ & ones , /n/ V/7( 8
.
S•• First Middle Last
Or, _ DSSov) .
Mailing Address(Number and street,city,sort.and ZIP code) [Same as pgpeny address
VOC --<* n90 • - Itp,nc4 ,
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 -andard deduction on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawfully,he or she ay be liable for back axes and subs .•tial financial penalties.
Owner I Signature Telephone
t1,11111W_.0 ‘ al ti-)b0
( )
��// PART 4:ADDITIONAL INF/ORMATION
�; CLAIM FOR HOMESTEAD PROPERTY 7AX
' CREDIT/STANDARD DEDUCTION
♦ � State Form 5473 (R614-03)
Prescnbed by the Departmen� ol Local GovemmeN Financ_
INSTRUCTIONS: See revcrse side loi lilinq insfruclions.
�l
FORM YEAR
HC10
��e) ce� Iha�n �st day of Mamh, 20_
I(We) occupied a ur p ncipal place of residence h following described real property for which a Homestead Pro r i eby daimed:
°�,('�{�`� 5° 70b5`
❑ I(VJe) owned ❑ Are buying under contract
� Have a benefiaai interest in the entity that is liable for the properry taxes on ihe pwperry and that owns the propetly� is buyy�gynder a contract.
If buying on contraa, Fee Simple owners name
Remrders oifice where contrad is recorded
County Tavnship
ar I umber Legal de�.
If any portion ol Ihe resiCentia sWCture w the d not
oi Ne pmperty utilized to produce inwme.
Rewrd number Page
ESCRIP,TION�.a,z� � .: ... . � _ . - ..- ,_-_•�`.,-._.r; ,:,:: ...
Tacing disiric� (city, fown, township) _�
S � I ls the property in question:
��� _ �= ❑ Real property ❑ Mobile Homo Q.C. 67J-7)
one (1) that immediate�rtounds that struUUre is used to Droduce inwme, describe Ue use antl portion
8y
M1�r�x?i'ASSESSDRLSEONLY . _ �� . TRUETAX ASSESSEDVALUE �-�HOMESTEAD -' .NON-RESIDENTIAL,�,
_.a�v.4 �.,:�< . ., t.,,:.a� =—T _ . . � VALUE � AT 100 /a OFiTTV S ' ' VALUE �� 'r? . � .: f "+ �VALUE:: �
Land not exceeding 1(one) acre immediately �� y� --
surtoundingresidentialimpmvements. (�) . �.�'�` - � I
Otherland (2) - _ �
Total land (line 7 plus line 2) (3)
� �L.::'.:: .
Dwelling (4) . :!:G^:. � � -
Residentiel improvemanLS or Annually � � .
Pssessad Mobila I Manufaclured Home Garage �5) - ..;_ _
Other improvemenis (6) I
TAaI improvements (line 4 through line 6) (7)
TUaI value (line 3 phs line n (g�
I hereby certify Ihe above is true, cortect, and Signawre ol nssesmr Da�e signed
wmplete.
Ventying actbn - Si9naWre ol Pudiror Date sgned .