HomeMy WebLinkAboutHomestead_Lauderback ■
SIAtE FORM l3!t ire/,W( TIESUIIR FORM 75-tA
.ArrRYR'EI BY STATE BO\RD(f.iRIRo:TS-`vv PRESCRIBED BY TIE OFFARi e.t(fLOCAL COVERYMETT FINANCE ICLI.i-r4.I
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homesead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead haul Homestead fraud causes higher tat bills for all;therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings,This information will he kepi confidential and can only be accessed by authorized county officials,The Depanmenl of
Local Government Finance will use this information to create toils that will help county officials eliminate homestead fraud. -
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Lauderback, Phyllis W
1123 S Race ST
Princeton IN 47670
1544
Phyllis W Lauderback
1123 S Race ST State Parcel Number LP_al Description
Princeton IN 47670-3031
I I I I I I I I I I I I I I I I I I I 1111 11111 111111111111111111111111
26-1 z-18-203-001.579-026 019-01579-00 SS ADD 214
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 I 1 Middle ` Last
��Cf{ � (I S (N . LAu OZAcerl ( V<
eg Addle' ao4ber and street,city,state,and ZIP code) 0 Same as property address
/ l� 3 S . 0C --- Si 79in)e 7-.0 Ft) n1, x-7416
Spouse First Middle Last
as..-----
1_Ct: ASc-$0
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last S digits) Drivers License/Stare ID Number (last 5 digits) Other(please specify in Part 4 below)
s= --
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.
Ow rTS"tore Date '
1
•
POPM HL 10 1979
PrescriGeE By Sta�e BoarE of Ta. Commissioners
� (We)-
�iarch, '
which a
ia Be FileE in Dupficate
CLAIM FOR HOMESTEAD PROPERTY_ TAX CREDIT' FOR YEAR 192� -
✓
. O/9 - o�s �9- �
SEE BACK FOR FILING INSTRUCTIONS
ace ot rasiaence
being claimed: .
I, (We) � owned
❑ are buying under contract
❑ have a beneficial ir�terest in the taxpayer
Property Description
Taxing District (City, T1�a; Tewrrsti�p): ��
Parcel Number
If buying on contract: Owners name �'� �""p1e °"'"ef�
i/, certify that on the tst day of
following described real property for
�• � �� 1 7
� �-�.L . y
or legal description shown on tax statement:
��r �
Contract recorded in Recorders Office - Record
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
Any other counties in which individual owns or is buying real property: County Township
� he a ve ate nt is true, correct and complete.
� ...�.�
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer. '
- FOR ASSESSOR'S USE ONLY :
Land not exceeding 1 on acr� imm te
surrounding resident�im�overjjents � �
Other Land �°
Total Land
�uv 2?,s�g
Residential Improvements Dwelling
���Garage
� Total
AUDITOR
Other Improvements
�Improvements - Line .(6) plus p) equals (8)
\�:�eby certify the above is true. correct, and complete.
Signamre al Assessor
Approved:
True Cash
Value
(t) � o 0
(p) '_
(3) �O t
�4� ��-
cs� _I � 3-70
(6) �
(�) �
(s) % 9l0 �
- ACTION BY AUDITOR -
Assessed
Valuation
� 70
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Homestead
Valuation
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Date: �