Homestead_Lewis (7) £I ME FoRm!JKIR f YMI iF£9ilrY.r00.N i>tA
.rrr En By grist Bwoor MY�.,�'ra_1rr Ma- TM BY THE orpARTEC OF LORE RVttrrn FP'AYCEr 6-II--"al
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to one hometead simian!deduction.As the receipt of This deduction becomes
' more beneficial.there is niece incentive than eser for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
• HEA 1344-7009 requires taxpayers who receive the homestead standard deduction to eerily that they are eligible to receive the
benefit and to provide additional identifying informaton necessary to allow county government to better monitor homestead
filings_This inform ation will be Lepi conhdmuial and can only he accessed by authorized county officials.The Depannent of
Local Government Finance will ua this infomution to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
— Taxpayer Name Property Address
Lewis, Gregory E/Wanda S
209 Olive Dr
Princeton IN 47670
3996
Gregory E/Wanda S Lewis
209 Olive Dr State Parcel Number Leal Description
Princeton IN 47670-3457
IrIrrIIruItllnlu tili Iluln�t it ltin tillnritln�rrlrl 26-12-18-403-001.995-028 019-01995-00 ROSS PLACE 25
PART 2:TAXPAYER INFORMATION
Owner I First " Middle • Last
�reoJo��(/ g. �wl -- e � � S _
Iltg Address(number used sneer,city,state,and ZIP code)-— —- — -- — — �Semc as properly addesi
Spotlit First Middle Last
kip aV ct., SV' e_ et„, ( s
Mailing Address(Number and street.city,state,and ZIP code) aCie as property address
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 b ck taxes and substantial financial penalties.
Owner I Signature Date
S
�,� ...,�
i � CLAIM FOR HOMESTEAD PROPERTY TAX
s� ` CREDIT/STANDARD DEDUCTION
SWie Form 5473 (R2 / 5-92)
�e�l `
INSTRUCTIONS: See ieverse side7orliling instructions.
. ,; . .. ... .' —=��CERTFICATI
FORM YEAR
HC10
- .r_ . .. � � -� _
I(We) niry that e st ay �o M r 78_
I(We) occupied as our rinci I lace of residence the Pollowing described real property for which a Homestead Prop�Ta�C�it�is he� daimed:
❑ i(We) owned ❑ Are buying under coniract ��• r� � tq9Ot�
�Have a beneficial interest in the entity that is liable for ihe property taxes on the property anr ::at �,s the property .s�b1�� �nAer a contraci.
/
�^
, � �,— � �
� � � - • -. CONTRACTRECORD',�j ' /�>��.% j" �l
If buying on coniratt. Pee Simple owner's name � � ' "" `' `''
I ,
Recorder's ottice where contract is recorded Record numDer
�..
Page
- � - � PROPERTY DESCRIPTION � �t'.��� _ , - . - . � -
Counry TownsNp Tazing tlistrict �dry, fowq rownship) �
r ��O Legaldescription
of Ihe residential simc[ure or Ne lantl not exceeding one (1) aae
y utilized to produce income.
surrounds that struciure is used to produce income, tlescribe the use and ponion
.� � � ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIOENTIAL. �_
. - VALUE YALUE� VALUE � VALUE .� .
Land not ezceeding 1(one) acre immediatety � - . -�-
surrounding residential improvements. (�) �� - �
Otherland (p� - : -
Total land pine 7 plus line 2� (3�
Dwelling (q) .. � �
Resideniial improvements . .
Garage (5) ' .
Other improvemenis (6) �
Total improvemenis (line 4 through line � (7)
Total value (line 3 p�s line � (g)
1 hereby certity the above is true, correct, and Signamre ol Asseswr Date si9ned
complete.
Ventyirig action - Synamre of Auditor Date sgned