HomeMy WebLinkAboutHomestead_Lashbrook (5)YEAR
CLAIM FOR HOMESTEAD PROPERTY TAX FORM
CREDIT/STANDARD DEDUCTION HCto
State Form 5473 IRS 110-01)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
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CERTIFICATION STATEMENT
I (We) certify that on the 1st day of March, 20
1 (We) occupied as our principal place of4esidence the following described real property for which a Homestead Property Tax Creg�%e�bq AM
9
❑ 1 (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 owns the property oiLbuyingA�r a
co tract.
08
CONTRACT' RECORDED
If buying on contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
PkoOtiiTYbWNEbBYCLAIMANTINOTHER'CbUhTIES
. —TRUE TA 'ASSESSED
-PROPERT.Y.IiESCRIPTIliN.-'.---,---
un
Township
I hereby certify the above statements are true, correct and complete. lure oclaimant ui
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zld4
Taxing district (r.q
y, own. township)
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�T100%0F.TT�
VALUE '
VALUV
VALLE
Land not exceeding 1 (one) acre immediately
Parcel n;;ber
Is the property in question:
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L6 ,
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�Real property ❑ Mobile Home (I.C. 6-1. 1-7)
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If any portion of the residential structure or the land not exceeding one (1) acre that i dia surrounds that structure is used to produce incorne, describe the use and portion
m/e ty
of the property utilized to produce income.
Other land
(2)
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v/ —Lae). oaf - oaf
PkoOtiiTYbWNEbBYCLAIMANTINOTHER'CbUhTIES
. —TRUE TA 'ASSESSED
County
Township I County
Township
I hereby certify the above statements are true, correct and complete. lure oclaimant ui
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zld4
at, city, state, ZIP code)
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7;� 7 7-,4
20 _ Pay 20_
Lesser of 112 Homestead
Valuatio"r $6,000
S
N mm_
. —TRUE TA 'ASSESSED
VALUE
�NOWRESIDEN; TIAL
at 56- &7 ASSESSOWUSE ONLY
V
�T100%0F.TT�
VALUE '
VALUV
VALLE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements-
Other land
(2)
Al I'
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
1s; -
Residential improvements
Garage
(5)
Other improvements
(6)
Total improvements (fine 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
20 _ Pay 20_
Lesser of 112 Homestead
Valuatio"r $6,000
S
N mm_
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MATE FO m.,,A.R./NNI TREASURER FORM 7.SAA
A?PRrWED BY M ALL MMRpm ufl*SR.]Da Ptfl 1Bm BY EKE DEPARThRNT(W LOCAL GOVERNMENT ra:AVCE M Ha-r4J
Gibson County Auditor
101 :J 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 become
more beneficial.there it more incentive than e'er for homestead fraud.Homestead fraud causes higher lay bills for all:therefore.
HEA I344-3009 requires taxpayers who receive the homestead standard deduction to aerily that they are eligible to reeene the
benefit and to provide additional identifyine informauion necessary to allow county government to better monitor homestead
flings This information will he kept confidential and can only he accessed by authorized county officials.The Department of
Local Government finance will use this information to create 4vla that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Lashbrook, Tim J
none
Francisco IN 47649
1274
Tim J Lashbrook
307E Wood St State Parcel Number Legal Description
FRANCISCO IN 47649-9085
26-13-20-101-000.022-005 012-00022-00 PARKVIEW 2/3PT
-PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
T' u S !I , +,.s -C
ig Address(number and irreet,city,gate,miii ZtY Bode) -- - — - - - — I^_I-Swuc ui propatty Gdte r" ---
30-7 k) Wood S. Pram r step ,TN (-! I is U 4 -id SS
Social Security Number(last S dM as) Drivels License/9-63-State ID Number (last/5(diiggitss))) Other(please specify in Part 4 below)
Spouse First Middle Last
f2lzneP CIS\ he L-ns ro0 /C—
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
301 P:. Wr-I,a .Sf". (2-r-an Ni t(71.0. 9 -?C 5
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
31a sategq - b9 -f 3r
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 Telephone
11.-01 //��s'' 4)09 )J.0 ) 79a-3374/
Spouse Signiors- Date Telephone
a;, /.;r- i - 'y/a9/i Ala ) 8 3 3
. Al �s 7
PART 4:ADDITIONAL INFORMATION .
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