Homestead_Lee (7) dam FORM SW•R3Is-101 IR:ASunz HR261 IS-IA
APPROVED BY rAtE 9o\RnOF.tt((INLLrm PRIWRa4UIIY T1a.OIPARIMER OF LOCALCOVEAS 14511POCE IC[C.1-224,'
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS,
101 N.Main Street Individuals and married couples are limited to one homestead stamlard deduction.As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tav bills for all:dxrfore,
IBEA 1314-2004 requiem taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
hearth and to provide additional identifying information necessary to allow county eovcmmcnl TO belier monitor homes)ad
filings.This information will be kept confidential and can only be accessed by authorized count'officials.The Depanmem of
n Local Government Finance will use this information to cr to tools that will help county officials eliminate homcucad fraud.
. PART 1:PROPERTY INFORMATION
FII,ED Taxpayer Name Location Address
Lee, Scott A/
2649 S 950E e
MAY 10 2012 OAKLAND CITY IN 47660
4774
C. . lI
2649 S I ON COUNTY AUDITOR milli III -III.Ii II DIIIIIIi oil II_III�II I_ III I��IIIII_II�II_ II
Oakland City IN 47660-8436
Ji
11"11111111"111'1111111111 I'II111'1III"IIIIIIiIl il11I1'I'l State Parcel Number Legal Description
- 26-13-27-200-000.878-006 PT NE 27 2 9 2.27 AC D-6 C-1
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.
_ r � - PAR 2' A:4'A ' ` 17 A I ` -
_r I First Middle Last
LSO lit- A loam
Mailing Address(number and street,city,state,and ZIP code) ['Sarre as propcny address
(90119 S 950 g-, Ooklavc/ City,/ AU L/ 766D
- .
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 Sig
e srxrp
CLAIM FOR HOMESTEAD
CREDIT /STANDARD DEDUCTION PROPERTY TAX
o State Form 5473 (R2 15-92)
INSTRUCTIONS: See reverse side for filing instructions.
MAY 0 7 2001
i
which a Homestead Property Tax Credit is hereby claimed:
1RI (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 or is buying under a contract.
- CONTRACT RECORDED
It buying on contract, Fee Simple owners name
Recorders office where contract is recorded _
Record number
Page
PROPERTY DESCRIPTION
County
Township
Taxing distri (dry, town, township)
Parcel number
Legal description
- c) '-. C)a
If any potion 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.
�L/ -017- -GCY1. d'7� 4a�
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township
County
Township
-reby certify the above statements are true, correct and complete.
Signature of claimant
(•�
Address((nnuumber and street cil)4 state, ZIP code)
/{ A, 7//
e /V q!(DtC/O
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
(1)
surrounding residential improvements.
Other land
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
Other improvements
(6)
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 Assesor
Date signed
complete.
Verifying action - Signature of Auditor Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead S
Valuation or 52,000
Signature of Auditor
Date signed
s- -o t