Homestead_Lance STATE FORM!l!NIR'/Wit ttLlS IIIR FORM 1IA •
• APPROVED BY STATE ankRD OF MRILSTS,yl PIFV[IIIDFD BY TIE DEPARnm'n(F LOLA'COttNMRCT FD:ASCE IC*-1.1-224.1
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 net for homestead fraud.Homestead fraud causes higher tan bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to creche the
benefit and to provide additional identifying nformaton nceesry to allow county government to better monitor homestead
filing.This information will be kept confidential and can only be accessed by authomnl county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Lance, Rick D/Kelly S
101 N Stormont ST
Princeton IN 47670
927
Rick D/Kelly S Lance
101 N Stormont ST State Parcel Number Legal Description
Princeton IN 47670-1839
It�tt��ttt�t��tt�rrt��� Illrrlr rrllrItlt tll 1111111I
26-12-07-204-001.545-028 019-01545-00 ARCHERS ENLG 4 PT
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
f, CKEY bit LL-- Z-ANC-E
®tg Address(number and street•city,state,and ZIP code) Same as property address
/0/ A) SrotcMoAi—r ST j%v e5—�2 Ili// I A) 4f7b70
-
Spouse First Middle Last
rELC-y c5UE 4/C.,
Mailing Address(Number and street,city,state,and ZIP code) tame as property address
lot /U &7o4410n/7 $r MA/Cr;7oN' /N Zf7/.P7v
-_ ___ ._—__� "____. -- .._-
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 Si ature
d��•�
E °. CLAIM FOR HOMESTEAD PROPERTY TAX
a��'� CREDIT/STANDARD DEDUCTION
.;,�,` r� State Fortn 5473 (R2 / 5-92)
�a.
INSTRUCTIONS: See reverse side for7iling instructions.
STATEMENT�
FORM
HC70
YEAR
(� 9. � P_P: n__w x�
���we) � r �/ C.e certify.that on the 7st day�lof'Mn ?�c�ji, 79
�;occupied as our principal place of re dence the following described real pmperty for which a Homestead Property�r�i"s FI�F81fy claimed:
LJ I(We) owned ❑ Are buying under contraci � � �j ��
❑ Have a beneficial interest in the eniity thai is liable for the property taxes on the property and that owns the p erty or i mg p�per a t(a
�� � � � ' � � CONTRACT RECORDED �-
If buyirg on Canlrati. Fee Simple owner'S name
Recorder's oHice where contract is recortled Record number Page
Count Township
�bso
Parcel number c/� ^ Legal des
—� l � Ti.l 'V �
If any portion of the residential structure or the land not
ol ihe property utilized to produce income.
PROPERTY DESCRIPTION �
�ctnQtii�trict (ciry, rown,
one (t) acre ihat immedlatety surr�nds that
� PROPERTY OWNED BY CLAIMANT IN OTHER
;ounry Tawnship Counry
�; y certify the above statements are true. correci and complete. Signamre o Gaimar
�
Atltlress (number and streeL dry.ydte. ZIP cotle) �� , ,
ASSESSOR USE ONLY �
land noi exceeding 7(one) acre immediately
surrounding resideniial improvemenis.
Oiher land
Total land (line 7 plus line Z�
Dwelling
Residential improvements
Garage
Other improvements
Total improvements (line 4 through line �
Total value (line 3 p�s line �
I hereby certify the above is tme, correci. and
complete.
"..i"'�a action - SianaWre ot Autli:or
of
19_Pay19_
Lesser of 712 Homestead
Valuation or 52,000
TRUETAX I ASSESSED
. VALUE VAWE
(ll
(2)
(3)
I4)
(5)
(6)
I�)
(8)
Signature ot Assessor
STANDARD
�
�
is used to produce income, tlescribe ihe use and ponion
HOMESTEAD
VALUE
_��
TownShip
NON-RESIDENTIAL.
VALUE
Date signed
Date siqnetl