Homestead_Lamar0� CLAIM FOR HOMESTEAD PROPERTY TAX
FORM YEAR
CREDIT/STANDARD DEDUCTION HC10
State Form 5473 (R614-03)
Prescribed by the Department of Local Govemment Finance,
INSTRUCTIONS: See reverse side for riling instructions.
4� 'V ' ;.f4,k Z',`,:CERTIFICATION STATEM
P
I (we) /h a./yn D"��M certify that on a let day of March, 20
I (We) occupied as our principal place of residence the following described real property for Which a Homestead JQ t Credit is hereby claimed:
I (We) owned ❑ Are buying under contract
Have a beneficial interest in the entity that is liable for the property taxes on the property and that ovgRr is buying under a contract.
If buying on contract, Fee Simple owner's name
office where contract
Record number I Page
��%_,',_-.TRUE7AXI,�.
cicitinty
Township
County
Tmdrig district lady, tom, township)
Parcel number
N-a'-(9 olq%-fDOL�AMt�ol
L g
as
Valuation or 535,000
1 11 the property In question:
I
Signature of Auditor
,R��TTWI
JEkd ❑ Real property ❑ Mobile Home (I.C. 61.1 -7)
If any portion of the residential structure or the land not exceeding we (1) am that immediately surrounds that structure is used to produce Income, describe the use and portion
of the property utilized to produce income.
��%_,',_-.TRUE7AXI,�.
-t�
County Township
County
Township
I hereby certify the above statements are true, correct and complete.
ign lure of ant
S"
ard street, ci�, state, li�rp code)
fr 0� ild A �;" o A
��%_,',_-.TRUE7AXI,�.
-t�
ASSESSED',VALGi
-f.tNON-. RESIDENTIAL
—ASSESSOR USE ONLY.0',"'W"'!
*0tiVALUEu]!,4'6?1,
,ATADP`5
Valuation or 535,000
.;�-.-�
Signature of Auditor
,R��TTWI
gr
Land not exceeding lone) acre immediately
surmunding residential Improvements.
(1)
Other land
(2)
"x'14-
;fir I
S
Total land (line I plus line 2)
(3)
Dwelling
(4)
0.
Residents] improvements or Annually
Assessed Mobile I Manufactured Horne
Garage
rp
(5)
improvements
(6)
'0JIher
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
I hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
-STANDARD-OEDUCTIONfALLOWANCE 'LLi.v
J"
mw 20 _ Pay 20
Lesser of 12 Homestead
Valuation or 535,000
S
Signature of Auditor
Date
STATE FORM!!Wr2'/sync T rSSUREA FORM SIA
PPM*EDGY MATE BOARDOf AM ST,._nn PILEATUDW BY mE DEPARTMENT OF LIXA1 GOVERNMENT FINANCE IC♦1.1-_-,I
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 exec for homestead fraud.Homestead fraud causes higher In bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to recehe the
benefit and to provide additional identifvinu information necessary to allow county.government to better monitor homestead
filings.this information will he kept confidential and can only ho accesud by authorized county°Rich's.The Depanmenl of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address -
Lamar, Sandra E
RI Box 1478
Francisco IN 47649
4450
Sandra E Lamar
405 N Division St State Parcel Number Legal Description
FRANCISCO IN 47649-9285
I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I I F I I I I I I I I t l l i I111 I I I I 26-13-18-404-000.198-005 012-00198-00 PT SE 18-2-9 1 AC
D-7
PART 2:TAXPAYER INFORMATION •
Owner I First Middle Last
SC\A1\ 1 i zc. e--‘ h L0.rn�
ng Address(number and street,city,state,and ZIP code) —� - -- 471,091
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number past 5 digits) Other(please specify in Part 4 below)
soe
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
PART 4:ADDITIONAL INFORMATION
•