HomeMy WebLinkAboutHomestead_Keeneth .. STATE FORM 53554(R3/8-10) - TREASURER FORMTS-IA
APPROVED BY STATE BOARD Or ACCOUNTS.NOR PRFSCRIBM BYTE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC 61.1-224.1
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 tax bills for all;therefore,
_ HEA 134.-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the'
FILED 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 homesteadfraud.
. . PART 1: PROPERTY INFORMATION .
MAY 10 2011 Taxpayer Name Location Address
C.3.1'^-n ----- Keeneth, Terry L/Antoinette A
12472 S Owensville Rd
GIBSON COUNTY AUDITOR - H 47639
IN 47639
2966 1
Terry L/Antoinette A Keeneth IIOI DI I IT OII I II I OI I III m11.11111 111IIOOl11IH 11)111l II I OII OI OIIOIIf I OIO I 1 1111
12472 S Owensville Rd - -
Haubstadt IN 47639-8651
I'III'llli'Llti"'111111'I"'1111111III 11II1I1II1IIII1I1IIII'III State Parcel Number - Legal Description
-- — 26-22-15-100-000.011-024 /PT NW 15 4 11 1.672 AC •
c.
This form MUST be returned to County Auditor's office. . .
'• Please do NOT send this form back with your tax payment to the county treasurerr
PART 2: TAXPAYER INFORMATION
First Middle Last
Mailing Address(number and street,city,state,and ZIP code) 't Same as property.address
a,.
c
-
Spouse First , -' Middle - Last
—Mailing Addrcsx(\t mbei and sti et city.state,and ZIP code) . . -. - _- - . - u-Same as property aadress • x - r—
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) - Other(please specify in Part 4 below) -
I I r S� . .
. - . -
.
•
e� �; CLAIM FOR HOMESTEAD PROPERTY TAX
i.,��'E CREDIT/STANDARD DEDUCTION
.
l/' Stare form 5473 (R2/ SB2)
a�.
INSTRUCTIONS: See ieve�se side /or7iling instructions.
' . � � . � � CERTIPICATI
F9 �� nJ E! 1 i•�. '�_ �
FO M� � � eYEARi
HC10
� ��
�� /,�. �Y+��s
I�^Ne) iV _���(�� ��1..�/ /l..t,(J(JYl ([��.�.L��[//LY.L%�tify that on the 751 day ot March, 19_
t
�) occupied as our princip ace of residence the following described real property tor which a Homestead Property Tax Credit is hereby claimed:
❑ I(We) owned ❑ Are buyin9 under contract �
❑ Have a beneficial interesi in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contraci.
" CONTRACT RECORDED ' � �
If buying on contract, Fee Simple owner's name .
Recorder's office where contract is recordetl Recortl number Page
Coumy
PROPERTY DESCRIPTION �
Tazing district (ciry, towq mwn5hip)
Parcel numb r Legal descriptlon
���I-�DO�I-C� �/Ul,�7 /S-y-I � �•<��7.
It any portion of Ne resitlential stmcWre or the �and noi exceetling one t) acre [hat immediatey surwunds ihat struciure is used ro produce income,
o� Ih2 prOP2rtY utili2ed to pfoduce income.
, , fii��%�//_I�.//�i
use and ponion
PROPERTY OWNED BV CLAIMANT IN OTHER COUNTIES �
Caunry Township � Counry Township
�by cenity the above statements are true, correct and complete. Signa o aimam
i
Address (number and streef. ciry. slafe, ZIP code)
� 3 l3
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE . VALUE VALUE
Land not exceeding 7(one) acre immediately
surrounding residential improvements. (�) -
Otherland (p)
Total land (line 7 plus line 7) (3�
Dwelling (4) � '
Fesidential improvements
Garage . (g) _ _ .
Other improvemenis (6) �
Total improvements Qine 4(hrough line � (7)
Toial value (line 3 p�s line � (g)
1 hereby certify the above is Ime. correct, and Signamre of Assessor Dare signetl
complete.
VP��tying action - Signature of Audi;or Date signed
79_Pay19_
Lesser of 7l2 Homestead
Valuation or $2,000
DEDUCTION ALLOWANCE
�
Signature ol Auditor � � � � I Date sig �
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