Homestead_Key (2) RIAIE RIR%I!NA IR'/AVM TRLASuRIA FORM fltA
.APPROVED BI'cT AFL KOR°01-ACTA ABTA_VV PREYAIarD BY TIE WEARING-AMOR LORAL GOVERNMENT FINANCE B'VI.Ira1
'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.I lornesteal fraud causes higher tax bills for all:therefore.
HEA 1343-3009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to teethe the
benefit and to provide additional identifying information necessary to allow county gmrrnment to better monitor homestead
filmy.This information will he kept confidential and can only be accessed by authorized county officials.The Depanniem of
Local Government Finance will use this information to create tools that will hap county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Key, Thomas L/Sue E
Chickasaw DR
- Fon Branch IN 47648
7611
_ _ Thomas L/Sue E_Key __ __ _ __ ___ _ _ _
900 Iroquois Dr State Parcel Number Legal Description
Fort Branch IN 47648-9523 ' LITILE I� 26-19-18-101-001.016-026 /38/50PT1�P ASE10RK VILLAGE
I PART 2:TAXPAYER INFORMATION
Owner I First Middle , Last
/
blow; k c !C 4 y
4.1ng Address(number and street,city,state,and ZIP code) ❑ Same as property address
9o0 ZRoeluors 1) iv C oRI" 521-ug H'7 e
Spouse First Middle
Last
gut /CC IN All V
Mailing Address(Number and street,city,stale,and ZIP code) ❑ Same h property address
' ?OD ko-011 o 5S big,'/J cr 40_4 A/C N .4-A1 976 r — —
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 'gnature Date
'.p
�E R`�3
e/= ; CLAIM FOR HOMESTEAD PROPERTY TAX
:��'.= CREDIT/STANDARD DEDUCTION
�,,;� State Form 5473 (R2 / 5-92)
�eTi �
INSTRUCTIONS: See reverse side !or /ilrng instructions.
.. �
��. �� 1_. F-: �I�} •
SEp - 31996
��We) uL�11.61wctJY �p,.� t q/ZlJ.4_CJUCSi✓ .L cenifythatoYS'frfefs����,.W9_
�) occupied as our principal place ot residence the following described re roperty tor which a Homestead Property Tax Credit is hereby daimed:
r' (We) owned ❑ Are buying under coniract . . .
❑ Have a beneficial interest in ihe entity that is liable for the property taxes on ihe property and that owns the property or is buying under a contract.
� � � � _CONTRACTRECORDED � - �
It buying on contrad, Fee Simple owner's name . . • . . . ' •
Recorder's oNice where contract is recortletl Record number Page
Counry
Parcel number Legal de n io
�I;1- aoi� �
It any portion of the residential simcture or the land not exceeding one
ot [he pwperty utilized to produce income. -
PROPERTY DESCRIPTION
tha�
fown,
t�at strucmre is usetl ro
�. .
use and ponion
ASSESSOR USE ONLY TRUE TA7C ASSESSED HOMESTEAD NON-RESIDENTIAL
VAIUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvements. (�)
Oiherland (p) � -
Totalland (line 1 plus line 2� (g�
Dwelling (4)
Residential improvements
Garage (g) �
Other improvements (6)
Total improvemen[s (line 4 through line � (7)
Total value (line 3 p�s line � (g) I
I hereby Certify the above i5 true, CorreCt, and Signature of Assessor Date signetl
complete.
�tying action - Signature of Auditor Date signetl
79_Pay79_
Lesser of 7/2 Homesiead
Valuatlon or 52.000
STANDAFD DEDUCTION ALLOWANCE
5
D • sig�etl
�-3-q_6- _,