HomeMy WebLinkAboutHomestead_Lacy ' STAR FORM a)NAIR_/fei T rAS:RIA FORM YIA ,
.APPROVED BY SATE IRMRDCW,CCIANTS.Zino FRFYWBFU BY THE DFFA RMENTOFLCEAL Gvpt'i,n FINANCE k 1.1-r.ti
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
• more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher tae bills for all:therefore.
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HEA 1344-7009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information neassary to allow county government to better monitor homestead
tilintw-This information will be kept confidential and can only le accessed by authorized county npicials.The Depanntent of
Local Government Finance will use this information to create tools that will help county official.eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Lacy, Lyman Robert
529 F Water ST
Princeton IN 47670
3066
Lyman Robert Lacy
529 E Water ST State Parcel Number Legal Description
Princeton IN 47670-2239
26-12-07-402-001.531-028 019-01531-00 PT SE 7-2-10.17 AC
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PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
L y�,n jZ� � ��t L�-�y
IIIg Address(nuttl0.t Will Stra t.City, ,a.,and ZIP code) -- -- _— _. sf71-c;, as property eddrn:.- _ _- _ _ __
r.2Y G- u_/.4-icz 5!, %�r?r.vcc[o .i � J-tt L'y`- `f-?c7o •
Spouse First Middle Last
Mailing Address(Number and street,city,stale,and ZIP code) 0 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)
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PART 3:CERTIFICATION
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 Telephone
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Spouse Signature 1 Date Telephone
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PART 4:ADDITIONAL INFORMATION
I
r�CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
/ Slale Fwm 5473 (R6 / 4-03)
Prescri6etl by the Department o( Local GovemmeM Finance
INSTRUCTIONS: See Bvcrsc side (or liling insfmr,Gons.
� � F�ORM � � � YEAR
, HC10 �
FEB 17 2004
� (We) �� :�� � ceitifgthat;ori the 7st'dayof�Mar�ch, 20
I(We) oaupi s our prindpal place of residence the following e uibed real property for which a Homestead Property Tac Credit is hereby daimed
�❑ I(We) owned ❑!ve buying under contract
�, ..
•,� ave a benefidal interest in the enfiry that is liable for Ne pmperty taxes on the property and that owns the property or is buying under a contract.
II buying on conVaa, Fee Simple owners name
Remrdefs olfitB where conVad is retorded
County Q Tamship Tatin d' t' t(t
Parcel n ber Legal descriptlon Is the
O/�i-O/ 3/-�
N any portion o1 the resiGential sWCture or Ne land not exceeding ona (1 � a�xe Nat immetliatey wnounds
of the property uGl¢ed to produce irkome.
County
County
Si natureofdaimant
I hereby certify lhe above statements are We, corred and complete. �
� �i�h�
Address (number end street, ciry, s(ate, ZIP cntle) _� � �
\��-c�7�r �__ w.�i�., s r . � 2�,��a �uv . L•�•�i�.av'�
Land not exceeding 1(one) aae immediately
surrounding residen6al improvements.
Other land .
Tdai land (line 1 plus line 2)
Dwelling
Residentiel improvementa or Mnually
Assessed Mob(le � ManuFa�urad Ho� Garage
Other impravements
Tdal improvements (line 4 fhmugh line 6)
Tctal value (line 3 plus line n
I hereby certify ihe above is We, corred, and
complele.
�Verifyi� action - SignaNre of PuOitor
of Nidita
20 _ Pay 20 _
Lesser of 1Y2 Homestead
vaWauon or E35.W0
(�)
(Z)
(3)
(4)
(5)
(6)
(�)
IB)
Signature olPssessor
S
Rewrd number �age
f�4..'c,�F ! � 4',{�'��`.yT�`fY �� 4:�b 4.
. if's 4ti 1��r S�C. � ���+/a'yt±�:31
u�hip)l
/�
ie5tion:
al Droperty ❑ Mobile Homo (I.C. 67.1-n
is used b produce incwne. desuibe the use antl portirn
Twvnship
� C ✓1R�_ �
signed
signed
Dale signea
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