Homestead_Kingsbury (3) SIMI TAM!!KI2'/NMI tMEASU D POOL:SIA
APPMwWn BY MATE bNPUM MTAIatc.]Iw RUY MUDDY THE DEPMTLERT(i LOCAL IXvrtNMnNr FINANCE It'6-11-VJ
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N Main IN 47670 Individuals and married couples are limited to one homestead standand deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than eta for homestead fraud Homestead fraud causes higher tat bills for all:therefore.
„ii HEA 1344-2009 requires tanpacers who receive the homestead standard deduction to verify that they are eligible to reeene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings,This information will he kept confidential and can only be accessed by authorized county Officials.The Ikpannent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Kingsbury, William R/Joyce E 3 too E' S R to p d
'4t3-Brr�.l98
Ilauhstadt IN 476390
10755
Joyce E Kingsbury
3600 E SR 68 State Parcel Number Legal Description
HAUBSTADT IN 47639
26-23-02-300-001.873-024 004-01873-00 PT W 2 410 2.00 AC
x D
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
u 0yCt g ve. l yea is< ; ?tc 5 z,LuYy
ng Address(number and sum.city,state,and ZIP code)
0 -_ -- ® Some as properN addresa - — - —-- - ----
34, bo E cS I? L- 8 Ha-(ib5fgdf, 9---A." 'yz& 39
Spouse First Middle Last
tr; «asea/
Mailing Address(Number and street,city,state.and ZIP code) ❑ 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)
Sot
PART 3:CERTIFICATION
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is toe and correct and that he or she is eliuible 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 r Date
°"� YEAR
Yy � CLAIM FOR HOMESTEAD PROPERTY TAX FORM
a�,��,e( `'� CREDIT/STANDARD DEDUCTION HC�o a�a�p�
�'�e.d+ State Form 5473 (R2 / 5-92)
' `�7y.'ii� �
�u�
INSTRUCTIONS: See reverse side (o� tiling insVUCtions.
. '. . " - .'� .... . ��... - ' ,-.:.CERTIFlCATIONSTATEMENT; ' •"'�`:" �-..._" � - :`..:"'�-;' �
'�We) -- � he tday a f 79_ .
�'e) occupied as our principal place of residence the tollo in descri ed real properry for which o tead Pr J e y daimed:
I(We) owned ❑ Are buying under contract G�BSOt: COU TY AUO�T�
❑ Have a beneficial interest in the eniity that is liable for the propeAy tazes on the property and that owns the property or is buying under a contraci.
Ii Wying on coniran, Fee Simple owners name
Recortler's oHice where contract is recortled
- ^c
Record number Page
. - . - . . .: � , - PROPERTY DESCRIBTION� ' . . ` � .'`•.-- e .., -. .' a"-.LL• . - .. -
Counry Township Ta�cing tlistnd (dry, fown, lownship)
Par I nu ber_ � � Legal tlescnption / � /1 `� — / O ^ _ /"� �
--� - ��� �; r-)
It any portion of Ne resltlentiai siruc[ure or Ne Wntl not ezceeding one (1) acre that immediately sunounds thai swcture is used ro protluce income, descnbe Ne use arM ponion
of che O�operry utilized to produce income.
-a3C,Y�-��.6�.3-
PROPEHTY OWNED BY CLAIMANT IN OTHEH COUNTIES ��� � � �
Couniy Township Counry Township
�;reby cenify the above statements are true, correct and complete. 5na:ure o� � am
I�
Address (numberarMStreeG ciry, stare. ZlPcode)
RR �o�c s�i P a�b Q ' �1. � 7(�3
. � ASSESSOR USE ONLY . � TRUE TAX ASSESSED HOMESTEAD � NON-RESIDENTIAC� � .
. , �� � VAWE VALUE VAWE = _ VALUE �-.
Land not exceeding 7(one) acre immediatety . . � � ,
surmunding residentiai improvements. (�) -
Other land (p) ` ��
Total land (line 1 plus line Z� (3)
Dwelling (a) . � _ , _ �.
,° ,
Residential improvements - � -
Garage (5) - �
Other improvemen[s (6) �
Total improvements (line 4 through line � (7)
7otal value (line 3 pbs line � (g)
I hereby certity the above is true, correct, and Synamre of nssessor Dare signed
complete.
"��lyirg adion � Signature of Auditor Date syned