HomeMy WebLinkAboutHomestead_Keil STALE IORM!!w,P`/I t FRrASOREA FORM:}IA
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Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individual and married couples are 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.
•
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to reecho the
benefit and to provide additional identifyme information necessary to allow county government to better monitor homestead
filing.This information will he kept confidential and can only be accessed by authorized county officials.The Depanmera of
Local Government Finance will use this information to create tools that will help county officials eliminate homcacad traud.
PART I: PROPERTY INFORMATION
Taxpayer Name Proper'Address
_ Keil, Anna M
/R3 Box
aubstadt IN 47639
11072
fruizaiuzo: 9o36 /9200 s
Anna M Keil ` HAS-CVO/ /A 41 703//zo
317 S Vine State Parcel Number Legal Description
...........,/
HAUBSTADT IN 47639 y
26-23-17-100-000.405-024 004-0040500 PT NW 17 4 10 1 AC
Ste ea o b- —A X \
. PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
Af/rg- /17 le /?E/C-
•tg Address(number and;amt,city,state,and ZIP code) .❑ Same as property address _- — _
.317 St 1/muc St /fiiu/ss7gD7 /N /�,f/76 37
Spouse First Middle Last
Ma dine Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number Bast 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sir
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
•
CLAIM FOR HOMESTEAD PROPERTY TAX
-'" " CREDIT/STANDARD DEDUCTION
��' J Slate Fam 5473 (R5 / 10-Ot )
� Presaibed by Ure Departrtcent d Local Govemment Finance
INSTR�IC�TIONS: See reverse side for (ling instrucfions.
FORM
HC10
YEAR
I(We) �'�/ '"�� certiy that on the 1sl day of March, 20_
I(We) pied as our prindpal place of resid nce the ollowing described real property for which a Homeslead Property Tac Credit is hereby daimed:
I(We) owned ❑ Are buying under contract �
� Have a benefidal interest in the entity Mat is liable for ihe property ta�ces on the property and that owns the prope or s�uyfq und��on�G
If buyin9 on conVact, Fee Simpie owners name
Remrdels ofire where coniraq is reoorded
County
Tamslup
u her Legal dascripdon
J �'�-�1W 17-4-I"a
H any po i ol� f Ne r entlal struqure or the land nW axceeEirq ona (7 � aae thet
W Me WupeM uGT¢ed tu Moduce i�oma.
County
I hereby certify the above statements are We, coned and complete.
Address (number and sbee4 �; stafe, ZfP code) ,�
/Is the property in n_ •
�..0 Rw oroaem O rnoeua Nomo u.c. �i.,-n
wrrounds that swGUre is used W produce inmme. desaihe the use arM portbn
otda_imaoy„ ,
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