Homestead_Luttrell SIMI FORM!Mee lr r!-NI 1R(ASeen EORH Is-t;
ARWn'ED BY SIME R[NRD OF Am5t<TSAT. ptrnaBED BY 171E DEPARTVF/T OF LOCAL COVERYM@.i FIANCE rH.l-Lit ..
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples arc 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 tax bills for all:therefore.
Ili HEA 1341-200c requires taxpayers who receive the homestead standard deduction to verity that they are eligible to receive the
benefit and to provide additional identifying infomemon necessary to allow county government to better monitor homestead
filings.This information will he kepi confidential and can only he accessed by authorized county officials.The Depann,enl 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 Pro r errs Address
Luttrell, Lisa M 1 ��j5 r @Vy)
a
570 .'h Pleasant RI)
eic re' I Eva. yr 'IN 47711
1
1387 $I D 5 x �usl IS-�'
Lisa M Luttrell `fir',t‘cako'n t .N u1 te10
810 S Hall State Parcel Number Legal Description
PRINCETON IN 47670-2332
1t1u11nJr11n1ur111undJu11uJ1tt t1t1nr 1111m.1t1r1 6-12-18-101-000.769-028/019-00769-00 L E WOODS 19
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' Mt Middle Last
L k5 P I ^n\t tAk-t- t t
1g Address(number and street,city,state,and ZIP code) �1 Same as property address
1D SL Kai St ) t?r;nce-k-oIn ( -LK( L u —10
_
Spouse Firstl Middle Last
Mailing Address(Number and street city,state,and ZIP code) ❑ Same as properly address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below) •
soar
PART 3c 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 ignature Date i.
•
�, RN� g CLAIM FOR HOMESTEAD PROPERTYTAX
CREDIT/STANDARD DEDUCTION
S j Slate Fam 5473 (R4I &W)
�•,.
INSTRUCTIONS: See reverse side for filing insWC6ons:
FORM Y
H�,o oa- b�
I(We) �i� cert' hal on the �t d f Mar 20//y�---
I(We) ocwpied as our principal place of residence the following described real property forwhich a Homes����i���
�(we) owned ❑ Are buying under contraG GIBSON COUNTY AUDITOR 1
ave a benefiaal interest in the entity that is liable for the properry taxes on the property and that owns lhe property or is buying under a contrad.
It Ouying on contrecL Fee Simple ownefs name
of Ne
Record number
Tawnship
Legal desaipUon .
Page
Vl/ ��Yi% �/V � � } C/ ` `iK�c�... ! � �
f ihe residential sWCWre w ihe land rwt exceeding on�'(1) acre Ihat immediatey surtounds Nat shucture is used to produce inmme, describe ihe use and portim
ulilized W protluce irKOme. � ' ' �