Homestead_Lumsdonr
N� CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
'y � State FOrtn 5I73 (R4 / &00)
INSTRUCTIONS: See reverse side for filirg insWC6ons.
ORM�� 1� Y�R
HC10:1 � Q� .
�
.ii
AUG 2 2 2001
I (We) / certify that-ai-tfie-ist.Eay'of,Marchi20 I
I(We) ocwpied.as our principal place of residence the following de bed real property for which a Homestead Property T�c Credd is hereby daimed:
❑ 1(We) owned ❑ Are buying under contrad
�lave a beneficial interest in the entity that is Iiabie tor the property taxes on the property and that owns the property or is byring under a contrad.
It buyinq on contrad, Fee Simple ovrnefs name
1 .
Remrdels ofice where contraC is recorded
Counry
Twmship
Legal tlesaipGOn
�.
w Ne land �at exceeAing one (7) arre th.
e: •
Tadng diSViU (city, fown. fownshiP)
li3 SurtWnAS th2t s Wre iS u5E
Record number . � Page _ .
income, Eescribe the use and
Gibson County Auditor
101 N Main
PRINCETON IN 47670
�� ����
APR 1 2 zutU
- `�°� '��
_ 01890N COUNTY AUDITOF
334 Jill Dr
PRIN N IN 47670
nrran:mar
IndividuaL and rturricJ tovpb are limi�ed �o orc homeseaJ 9a`MaN ANunion. As the receip� of �hisjdedunion bccrnre�
murc beneficial. thrre i. morc incenme than rcer for homcsmad frauJ. HomnttaA frauA nuses higM tan b('lls tor all; therefae.
HEA 13�ti-?009 requ'un u�payen ..�ho recci.e ihe hwnesteaJ standa�J JNuction w.erify thn� �hcy are e(cible m mcei�e ihe
benefit anJ ro p�w'idr additiunal idenui�'fnc infwmation nem�n� to allou' cwnrc grn'emmait to W.u:r�monitor twme�te;d
filim�.'Ihis in(armatieu� �ill 6e Aep conlidrmial and on nnly M accessnl by awhar'vN rounty oRcial��The Ikpannmm o(
Local Gm<rtvnrn� Fiv'rce ��ill use this intumiation �o vr<atc 0.vle that �cill hcln �ounn' olficials dim�ni�e hum<>�ead fraud.
Taxoaver Name Propertc Ai
Lumsdon, Kenneth R/Mary M //
� � i�/%%� \o Location [
W~
�-/G(I �
v ) � I State Parcel Number Lesal Descri
(���� zs-»-�5-�0�-ool.sss-oz� so�o,sse-oosnr,o
!
__ _ __ _ . .. .� _ /_ _ _ ___ ._
v
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
Address (numbcr en� �rteet, city, smle, end ZIP code)
�sc�� 1,�e5�- -� � I p�,` �
��
s(Number and stm4 cil}'. lale, and ZIP code)
� es� �il
,
D����
Snmc as pmpem addms�
(plcue specify in Pan 4 bdow)
� (� " i
as pmpeny add�e55
(plcuc specify in Pan 4 bclow')
undersiened certifies, under penalty of pequry, that the abo��e and foregoing infonnation is we and wrrect and that he or
�e the homestead standard deduction on this property. Each undersi¢ned al>o understands that, by claiming additional hom
rfully, he or she may be liable (or back ta�ces and substantial financial penalties.
I ewnve n i i�C I�tc 'I'dcohonc �
��
�
/� --• - - � ��