Homestead_Kays STATE10RM!311 1R_1✓NI TREASURER FORS(TSIA
%FIRMED BY STATE',CAROM A/5UA Ti.`vn r.FYF1am BY OW DEPARTMENT OF LOCAL roerEs'NRET iNA'CE IC 6-I.1:_10
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNEkS
PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
IP HEA 134:-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 information will be kept conl dmuial and can only he accessed by authorized county officials.The Department of
Local Government Finance will we this information to create 40Is that will help county officials eliminate homcncad fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Kays, Howard/Joan
R I Oox 27
au stadt IN 47639
11140
— -- Howard/Joan Kays -- - —_ — -- -- ,, —— —�
12526 S 40 W State Parcel Number Legal Description
Haubstadt IN 47639-8715
Itlttlltttltlltttt 1111111 tlttlt'tttltlill tlrltrIIIItIIl IIlIm ll 26-23-18-300-000.762-024 004-00762-00 PTWSW 18410 .55 AC
PART 2: TAXPAYER INFORMATION
Owner I First' Middle Last
C goat M Kays
ig Address(number and street,city,state.and ZIP code) -- - - U Same as property address - -
1 a5a (o -5 9-o lit/ yau6stodt // -S( 87639- S17/5-
Spouse First Middle Last
Mailing Address(Number and street city,state,and ZIP code) _ -_ -- - - i- _—a Same as pmpeny address _ - -
Social Security Number(last 5 digits) Driver's Liccnse/Stare ID Number (last 5 digits) Other(please specify in Part 4 below)
sea
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 1 Si tore Date
•
e�� RI�
°4 CLAIM FOR HOMESTEAD PROPERTY TAX
i��'� CREDIT/STANDARD DEDUCTION .
�;.�� State Fortn 5473 (R2 / 5-92)
isu •
INSTRUCTIONS: See reverse side (or liling inshuctions.
� - � ' ' - CERTIFICATI
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.e) / ` � certify.thai on�the 1st day of March, 19_
� �vJe) occupied as our principal place residence the following escribed real property �for which a Homestead Property Tax Credit is hereby claimed:
��l (We) owned ❑ Are buying under contraci .
❑ Have a beneticial interest in the entity that is liable for the property taxes on the pmperty and thai owns ihe property or is buying under a contract.
� CONTRACT RECORDED� . . ' ,
If buying on contract, Fee Simple owners name ; _
ReCOrder's oftice where coNract is recorded Record number Page
Counry
Parcel number
If any ponion of the r����
of th2 Pmp2rty utiliZetl t0 pn
PROPEFTY DESCRIPTION
Township
rown,
� � I Legal tlescri � _ / • ' 71.L /� / / �/ �
o% O , �o�
stmcture or the land not exceeding one (1) acre thai immetliatety surmuntls that structure is used ro produce inwme, describe the use and portion
ice income.
ASSESSOR USE ONLY � TRUE TAX ASSESSED HOMESTEAD NON•RESIDENTIAL
� VALUE VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately
surrounding residential improvemenis. (� �
Otherland (2)
Total land (line 1 plus line 2� (3)
Dwelling (4)
Residential improvements �
Garage (g) �
Other improvements (6)
Total improvements (line 4 thiough line � (7)
Total value (line 3 p�s line 7� (g�
I hereby certify ihe above is true. correct. and Signamre of nssessor oate siqned
complete.
'�yirg action � Signature of Auditor Date signed
� - STANDARD DEDUCTION ALLOWANCE -
19_Pay19_
Lesser of 1/2 Homestead
Valuation or $2,000 5
Signat f Auditor - Dare signed
� . .— , ._. 1 � 'y --- ._.—_ . �� — i