Homestead_Lashbrook (2)°' CLAIM FOR HOMESTEAD PROPERTY TAX
:. -- 7 t CREDIT/STANDARD DEDUCTION
Stata Fam 5473 (R8 ! 7-07)
•� �u. Prescnbed hy Ihe DepaNnenl of Loml Govemment Finence
INS7RUCTIONS: See reverse side for filing instiuclions.
#- " i ?� 7�
OCT 2 2 2008
I(We�yj�Q-/V`C�O� �' ���"'l�C� //(Fj�����,.l1�4"a"�v certify�hato�rl���Qst�ay�otMaich,plTOR
1(We) occupied as our principal place of residence the tollowing described real property for which a Homestead Pmperty Tac Credit is hereby daimed:
I(We) owned ❑ Are buying under contract
Have a benefidal interest in the entiry that is liable fw the property taxes on the property and Nat owns the property or is buying under a contract.
If buying om m�tract, Fee Simpe ovmefs name
RecorEers afice where wMact is recortled
Counry Twvnship
(cNy, to�. fm,vnshiP)
RBtord number � Page
Pa¢el number I Leg tl scnpGon � /� I Is the property in queslion:
�� G�� di� , ❑ Real GmPertY ❑ Mobile Home (IC 67.7-7)
If any portion of the residen6al sVUCture or the land n exceeding one (t ) acre Ihat immediately wmountls ihat strucW re is used to piotluce income, tlescnbe the use and potlbn
otihe properry uGGZetl b produce income.
a(,-//- l3- �oa-000. y 4�-oa�
.- .
, . .. . ,
„.. �
Land not ezceeding 7 (o�re) aae immediately -.' ``"', -" ' '- - ; " . <. %.`• `"'� � �
surroundirg residential improvements. ��� - ' �
Other land �Z� � ' -
Tdal land (line 1 plus line 2) (g� -
�h
ResidentialimprovementswMnually ����� �4� ..'.sY,. �",-
Pssessed Mobile / ManufacWred Home � � fi...?
Garage �5) - ur z��.- �
.r 't.
Other improvemenfs (6) � . � �� -�� =' .
Ttial imprwements (Irne 4 through Gne 6) �7)
TUaI value (line 3 pl,s line n �g)
I hereby certify the above is We, cwrect, and signawra otAssessor Date signed (monN, day, yea�
complete.
Verifyirg aclian - Signature of Auditw Daie signed (mmN, day, yea�
�' �.-� � � • •
.. _ pay 20 _ qs ppp tor 2007 pay 2008 42,000 for 2070 pay 2071
Lesser of 1f2 qq.000 for 2008 pay 2009 41.000 for 2077 pay 2012
Homestead Valuation S
w 43,000 for 2009 pay 2010 40,000 payable after 2072
Signature of Auditor Dale signed (month, day, yea�
$lAtEf01[X!l'XIF:IS�MI I RlAS11AfAPo0.NilA
n��Rlw'EDBI"cl1iFDMRDOi.iRV1:�T3.y.� PA[S1UBmBYiHfUE�M1�6.Yf(iLUAlCAn2R.wp.ilP�\'CEII'VI.1--J.1
Gibson County Audiror
101NMain '�' • � 1 / 1 ••�' • ��
PRINCETON IN 47670 LWiriJuals and ma:riN mupb are Iimiied io onc home�tead aandaN J.�lunion. As Ihe �eceip� of Ihix deduc�ion Mcome�
morc bcneficial, therc i> morc incrntne tfun e�er for homesread traud. Iloma�tad fraud causa hi�M �ac liills tor all: Ihertfwe.
• HE.\ 13�1-f-30U9 requires uapapm v:ho rerei.e the hanesreaJ siandard deduction in .erity tMi �Aey are elieiWe �o mcei�e �hz
benefi� an1 to p�p�idr adititio�ul.identiirim� information mar;an� to allou� counn� gaemmenl ro bemi rtwnitor homesreaA
fili�. Thfs informalion xill 6e Aqv cmrturn�iai and qn onlp lx acressed by authorizerl rounry� n�T¢iol:. TM1e IkFunnrent of
I.oral Gwemmem PimMC will ux �his inlortnation �u crcau [wls Ihat �rill h:Ip cwnq' of&ials eliminate homestcal haud.
_ Tasnarer Name Prooenv,
� � � Lj � Lashbrook, Travis/Alicia
� 1,
J POI:
L U 1 U Princ�YOn
aes APR 1 3 �
Travis Lashbrook �
567 W Poplar Ave ya���/
PRINCETON IN 47�7� p�NTY AUDITOR State Parcel Yumber Leeal Desc
26-11-13-202-000.498-027 006-ooasa-ao POF
�i�n��n��i��u�u����nni�i�n��u�i�i�i�ni��n��n�i�n�� �
HILLS 16
__ _ . _ . _ �_ _ __ _.._.__ . —. _ —_ _ __.__ __ .p__
This form MUST be retumed to County Auditor's office.
Please do NOT send this form back with your tax payment to the county
0
Addrtss (num6er und stteet, ciry, seate, and ZIP code)
I�R7:nIC�-�a� , .�r�
ID �mnber (lan 5 digits) Oi
Hl.S4T'J� I UA�N
Address (Number and sv«t, city, staie, and LIP cude)
Slo� W �oPLAR Av� P(�rNCrJrv�
Itturiry� Numbcr (last 5 di¢irs) DrivcYs Littnsc/Sta[e ID Niunbcr (laa 5 diF
�-RS�3R oUK
� Snmc us pmpem oddrcv
U
:cify in Part 4 belax�)
� $ame u p`openy addres:
�{l ca�! o
(please s�eciF in Part 4 helow•)
urer.
Each undersigned cenifies, under penalty of perjury. that the abo��e and foregoing infortnation is true and cotrect and that he or she is eli4ible to
receive the homestead standard deduc�ion on this property. Each undersiened al>o unders�ands that, by claiming additional home:�tead deductions
unlawfully, he or she may bz liable for back taxes and substantial financial penalties. I
O..Mr I Si�manve Dste 7'cicphme ;
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ure � /7 n
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