Homestead_Kolhouse STATE FORM 53560(0.3/t-tO) TREASURER IOtM TS-IA
APPROVED RY SATE BOARD OF ACCOUNTS.2W3 PRESCRIBED BY THE DEPARTMENT OF IOCAI.GOVERNMENT FINANCE ICS-n-224.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
_. •'lfi'.,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 tax bills for all;therefore.
IF HEA 1344-2009 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 infom5ation will be kept confidential and can only be accessed by authorized county officials.The Department of
FILE]) Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFOIL\IATION
_ MAY 1 244 Taxpayer Name Location Address
Kolhouse, John R - •
C. ,ry 3095 Mccreary(VV\
Pod Branch IN 47648
22&OSON COUNTY AUDITOR II II III IIII
John R Kolhouse II I�III-ulll[II I��IIIGIGII GilIIIIII lul �IfliiiII?IIIGillJt II�III�llII�II�I�III_IIII
309 S Mccreary ..
Fort Branch IN 47648-1535
11111111111'1111111I111111'1111"1'11111111111111'111 '1111'11111 State Parcel Number Legal Description
26-18-24-202-000.509-026 BERTHA LINTZ 5/6
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 "' .
O.. . I First Middle - Last
tl
io\va I� Iek�26 Cu Uous-e
Mailing Address(number and street,city,state,and ZIP code) Same as property address
.
Spouse First Middle ' " Last
-- Maiiiag Address l(NUmbe(and street.city:state,aild ZIP calei - _ — _ _—''Same'as property edeu ens
c7
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 fmancial penalties.-
Owner • tore Date
� s-="" o
: ��-
i
d
CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION . •
State Fortn 5473 (R2 / S92)
INSTRUCTIONS: See reverse side lor /iling instructions.
FORM
HC70
YEAR
RTIFICATION STATEMENT
I(We) � certify th th t _
I�(W�e) occupied our principal place of residence the follovring described reai property for which a Homestead Properry Tax�r�Q�t i�h�yretryOc��imed:
`�I (We) owned � Are buying under contract � b L U
❑ Have a beneficial inierest in the eniity that is liable for the property taxes on ihe properry and that owns the prope is buying u de ontrac
CONTRACT RECORDED GIBSON COUNTY AUDITOR
11 buying on conVact, Fee Simple owners name
• Recorders oKce where comrnct is recorded Record number Page I
PROPERTY DESCRIPTIO -
Counry Township Ta<inq tlistri �ty, to , fownshi
el u ber `O _ description
If any ponion oi ihe residential siructure or ihe land not exceeding one (7) acre that immetliatey surrounas Nai swcture is used ro produce income, describe ihe use and ponion of
the property utilized to praduce incame.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES '
Counry Township
I
' Si9na of aiman� I
ereby certify the above statemenis are true, correct and complete.
i
Address (number and stree(, ciry, state, ZIP ootle)
3o S S Ni e a�,ac F 7 s�
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VAIUE VALUE VALUE
Land not exceeding t(one) acre immediately �� �
surrounding resideniial improvements.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4)
Residential improvemenis
Garage (5)
Other improvements (6)
Total improvements (line 4 through line 6) (7)
Total value (line 3 pfus line 7J (8)
I hereby ceRify the above is true, Correct, and Signawre ol Assesor Date signetl
complete.
Verifyinq action - Signawre of Audiror Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead �
Va ation or S2,00
Sgnature oi Audiror D tegsjgnetl ^ Q�
U !