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Gibson County Auditor 101 N Main
.- IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limbed to one homestead sundani 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 1244-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit anti to provide additional identifying information necessary to allow county government to better monitor homestead
tiling.This information will he kepi cnnl'dent ial and can only he accessed by authorized county officials.The Department of
Local Government Finance will me this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Pro s erty Address
_ Kelley, Carl W/Beverly
RI Box 261
siiam
Francisco IN 47649
4. •
Carl W/ Beverly Kelley
R1 Box 261 State Parcel Number Legal Description
Francisco IN 47649-9042
26-13-21-100-000.341-004 002-00341-00 E SW NW 21-2-92 AC
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PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
a/a Z- de • i?a //ely
11111 ng Address(number and street,city,state,and ZIP code) - —
72 P 4 Sr Rh 4 / /=i2,*,g) 156e> c 0.
Spouse First Middle Last
eniztie X /ijlrey
Mailing Address(Number and street,city,state,and ZIP code) (T e11e as property address
11/D f', S� ?k • 61 F9-1M4,-Ce-c Ll44lt•-)
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
0
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
_ CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (1712/1 -90)
INSTRUCTIONS: See reverse side for filing instructions.
CERTIFICATION STATEMENT
I (We) JO l.!Alf— (�/. � certify that on the 1st day of March , 19 90
10"We) occupied as our principal place of residence the following described real property for which a Homestead
operty Tax Credit is hereby claimed: 1 (We) owned ❑ Are buying under contract
El property a beneficial interest in the entity that is liable for the property taxes on the property and that owns the
property or is buying it under a contract. q<gqrT W T0%
CONTRACT RECORDED
If buying on contract. Fee Simple Owner's Name APR 2 7 19
Recorder's office where contract is recorded Reco .N Page
AUDIZ
PROPERTY DESCRIPTION
County Township a- Taxing District (City, town, township)
Parcel Number Lega� ,;, ,pt�iop, . � � -
ad a- o0 3/00 ,O{,�J
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that struc-
ture is used to produce income describe the use and portion of the property utilized to produce income.
- 3- - �/o- Goo•3f / -GQ
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
ASSESSOR USE ONLY TRUE TAX VALUE ASSESSED VALUE HOMESTEAD VALUE NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements
Other land
Total land - line (1) plus line (2)
Residential improvements Dwelling
Garage
Other improvements
Total improvements - line (4) through line (6)
Total value - line (3) plus line (7)
(1)
1991 Pay 1992
Lesser of 112 Homestead
19— Pay 19—
Lesser of 1/2 Homestead
Valuation or $2,500
(2)
Valuation or $1,500
Valuation or $1,500
(3)
Signature
(h^ -mac. �"• s
(4)
(5)
(6)
(7)
(8)
1 hereby certify the above is true,
correct, and complete
Signature of Assesor
Date Signed
Verifying Action - Signature of Auditor
Date Signed
STANDARD DEDUCTION ALLOWANCE
1989 Pay 1990
Lesser of 112 Homestead
1990 Pay 1991
Lesser of 1/2 Homestead
1991 Pay 1992
Lesser of 112 Homestead
19— Pay 19—
Lesser of 1/2 Homestead
Valuation or $2,500
Valuation or $2,000
Valuation or $1,500
Valuation or $1,500
Signature
(h^ -mac. �"• s
Date ignerjl
o2 9 0