Homestead_Kiesel (7) •
- • STATE FORM 53599(0.1/.IO) TRFASLRra FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS EW YREtCRIBED BY 111E DEPARTMENT OF LOCALCAVIANMENT FINANCE IC 6-1.1-22•1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud-Homestead fraud causes higher ax bills for all;therefore,
Akr— �r--� HEA 1344-?1109 requires taxpayers 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 government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
MAY 6 2011
Taxpayer Name Location Address
Kiesel, Linda J
814 E Strain
GIBSON COUNTY AUDITOR Fort Branch IN 47648
2678
Linda J Kiesel 111111 II]hill III EMI II 111111111 111111 111111 11r 111111111II I1III. II
814E Strain St
FORT BRANCH IN 47648-1464
11t11111'I'1111'11111"'I"11111"'l IIF11111t11111111111"111111' State Parcel Number Legal Description
26-19-18-304-000.873-026/ PT SW 18-3-10.96 AC PT NW 19-3-10 .17
•
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2: TAXPAYER INFORMATION
First --- Middle Last
L iNOR- T/+N _F X JESEL
Mailing Address(number and street,city.state,and ZIP code) ® Same as property address
Spouse First. Middle Last
Mailing Address(Number and street.city,state,and ZIP code) El Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
Ir
I I I I I I I I I I suite
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 Signature Date
[�c `—r,�ry
e� °' g CLAIM FOR HOMESTEAD PROPERTY TAX
i��: CREDIT/STANDARD DEDUCTION
.�,,�'� State Form 5473 (R2 / 5-92)
�si�
INSTRUCTIONS: See reverse side for liling instructions.
���.FORM YEAR
`_�
� ,a -e`'�' , .�' �
�pY 10 1996
I(We) �Jld^�tT �.`f- a certify ihat on the 7si c1!{+IiUAArAN�14�,�
�'e) occupied as our principaf place of reside e the following described real property for which a Homesiead Property Tax Credit is hereby daimed
i I(We) owned ❑ Are buying under contract . - .
❑ Have a beneticial inierest in the eniity thai is liable for ihe property taxes on the property and thai owns ihe property or is buying under a contract.
CONTRACTRECORDED . �
If buying on contrad, Fee Sunple owner's name . _ . ' .
Recortler's office where contract is remrdetl Recortl numher " Page
County
Parcel number I
ott -�8"13
If any portion ot the residential stmcture or the
of ihe property utilized to produce income.
� PROPERTY DESCRIP'f10N
A - �I- Taxin di5t ip fc�. , town,
I�'\ �� nQ�
cription
oSW 18�3-10. •q(, �. �N�
exceeding one (1) ave that immetliatety surmuntls that strw
�-iv .� i � ry-�
used to produce income. desuibe the use antl portion
C c_ �
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE' VALUE VALUE � VALUE
Land noi exceeding 7(one) acre immediately
su«ounding residential improvements. (�) �
Oiher land (2)
Total land Qine 7 plus line Z� (3)
Dwelling (4)
Fesidential improvemenis
Garage (5� �
Other improvements (6)
Total improvements (line 4 through lina � (7)
Total value (line 3 pbs line � (g�
I hereby certify the above is irUe, corrett, and Signamre ot Assessor Da;e signed -
complete.
Veritying action � Signature of Auditor Dare signetl
��
79_Pay79_
Lesser of 7l2 Homesiead
Valuation or S2,000
STANDARD DEDUCTION ALIOWANCE
�
^ • ,�/�� ' IDa;esignei
�� �i v l 5