Homestead_Lynch SDTE FORM ns IR-r`,PO TREANa1A PORN-•FlA
ArrRO.'En AT',TATE WARD OF■VTR:yT%."op PLUYArBFD BY THE DEPARMENTOF LOCAL tfxtRVw.n.'t 1NANCE M V1.1-224.I
Gibson County Auditor
11 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
! 11111 more beneficial,there is more incentive than roc for homestead fraud.homestead fraud causes higher tat bills for all:therefore.
HEA 1343-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necesory to allow county government to better monitor homestead
tilintp.This information will he kepi confidential and cm only be accessed by authnrived county officials.The Dcpanntent of
Local Government Finance will use this information to create teals that will help county officials eliminate homestead fraud.
- PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Lynch, Roy I
' 670
1155
Roy Lynch I
1500 S 350 E State Parcel Number Legal Description
Princeton IN 47670-8814
1 1 11 IIII III IIII III III I I III 26-12-14-300-000.411-0 4 002-00411-00 PT SW 14-2-10 92 AC
r n rn r u nr nr a m rru r n nr nu r r C-1 D-10
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
�g Ada—rds(number mtd trcct,city,state,and ZIP P code) — - - — - -Same as property addrw -— — — — - - - -
/5aa 5 356E -y7,�mvtiii.) . 517 74
-
Spouse First Middle Last
in>/11)i `L 4y e
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
/V10 -C .s''Sb t yi/Y,I.�.n�cJ ) 77/-,74)
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 S' more Date
CLAIM FOR HOMESTEAD PROPERTY TAX FORM YEAR
CREDIT /STANDARD DEDUCTION HC10
State Form 5473 (R2/5-92)
INSTRUCTIONS: See reverse side for tiling instructions.
(We) _, 1.,. r YT certify th , on the 1 s da ` arch. to
�'e) occupied as r principal place of sidence the following described real property for which a Hom ' ead Pro e y T redit e e aimed:
I (We) owned ❑ Are buying under contract AUDITOR
❑ Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
CONTRACT RECORDED -
It buying on contract, Fee Simple owner's name '
Recorder's office where contract is recorded Record number Page
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
TRUE TAX
VALUE
PROPERTY DESCRIPTION
County
I Towns b
1
Taxing " ict (ci y, town, township) -,
Parcel number
ooa - oo
Legal
Adtlress/ (gyrpbe},d s'reeG city sta Pcode)
If any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
Total land (line I plus line 2))
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
TRUE TAX
VALUE
County
Township
County
Township
®:reby certify the above statements are true, correct and complete.
Signature o' tai ant
Adtlress/ (gyrpbe},d s'reeG city sta Pcode)
Other land
I
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Valuation or $2,000
-
Other land
(2)
Total land (line I plus line 2))
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
-
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
-
Total value (line 3 pfis line 7)
(g)
I hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19 Pay 19
Lesser of 112 Homestead
S
Valuation or $2,000
Signature of Autlitor ( \��
v •
Date signed
_ _
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