Homestead_Lemmons STATE FORM 5150(u'6-10) - TREASURER FORMS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,aP FRESCRIBED BY TOE DEMITME\'r OF LOCAL GOVERNMEYTFOtAMCM IC 6.1.1-334.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N.Main Street Individuals and married couples are limited to one homestead standard 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 tax bills for all:therefore.
_ HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county merriment to better monitor homestead
�7 filings.This information will be kept this information to can only be accessed by authorized county officials.The Department of
FII_, D Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
1: PROPERTY INFORMATION
MAY 6 2011 Taxpayer Name Location Address
Lemmons, Gary M
1962 S Whispering Hills Rd
G9N COUNTY AUDITOR , OAKLAND CITY IN 47660
111111111IIII111111I11 mil 1Ifil imi-111111f 11 IliT ff1111111 _ III Gary MLemmons
1962 S Whispering Hills RD •
Oakland City IN 47660-8663
IiIlllllllrlttllllt 1111'lillltl'I"1I'I"IIII1'1I1'I1I111rll"III State Parcel Number Legal Description
26-13-23-101-000.823-006 SWEET BRIAR EST 8PT PT NE 23 2 9
• .1492 AC C-1D-6
e.
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 __- __-___-_____ _.__-_- PART 2: AXPA1 ' t 8 ', A S:
Ow- - 1 First I//�y/'1\ Middle yt /� - Last
^
Mailing Address( ber and street.city,state,and ZIP code) me az property address
Spline Firstl 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 (last 5 digits) Other(please specify in Pan 4 below)
I I I I I I I I I Star
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 fmancial penalties.
°per I Signa Date
iCLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
•• )' State Form 5473 (8215-92)
INSTRUCTIONS: See reverse,side for filing instructions.
FORM
HC10
TT.
YEAR
CERTIFICATION STATEMENT n —
I (We) na certify thaat1t"�o��nyve 1 st day of March, 19_
I (We) occupied as our principal place of residence the following de ed real property for which a fHesh ead ro errY Tak Credi he y claimed:
We owned Are b m under contract �( ) ❑ uY g IeR Ot. C�t ".. Y i'JITO^n
Have a beneficial interest in the entity that is liable for the taxes on the and that owns the or is buying under a contract.
ki property property property
CONTRACT RECORDED
If buying on contract, Fee Simple owners name
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
County
Township -
T d ct (dry, town, township)
Parcel number
Legal description
3-
-
Ifany portion 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.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County Township
County Township
Signature of claimant
ereby certify the above statements are true, correct and complete.
ddress (number and street, city, state, ZIP code)
gal. 2 �� 4 AA o/J.�GA.✓o �iTr-i Sw ci�6Co
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)
1 hereby certify the above is true, correct, and
Signature of Assesor
Date signed
complete.
vedtying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_ Pay 19
Lesser of 1/2 Homestead
$
Valuation or $2,000
Signature of Auditor
Date signed
-a a