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Homestead_LambertCLAIM FOR HOMESTEAD PROPERTY TAX FCREDIT /STANDARD DEDUCTION State Form 5473 (R8 / 4IXi) }7�� Prescribed by the Department of Local Govemment Finance _ INSTRUCTIONS: See reverse side for riling instructions. I (We) certify that ^the 1 st day of March, 20 p r ,,II ((we) occupied as our principal pla of residence the following described real property for which a Homestead Pro / -,Ter Cred hereby dal r rd: (We) owned ❑ Are buying under contract GIBBON C" WIi ALIDITOR 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. -cV."Wftwm' Us�F.r', -'mss: ..>��n: i `. -= "al"•,'ti.yu'�t4''s'3sawwNTRACT ;RECORDED -F'Y "�F^LS.a "i�ih2 >5 s�rc" - ,.+"tS'_i k t --A•'c ;a 3 If buying on contract, Fee Simple owners name Recorders office where contract is recorded Record number Page 3?,''�Fks•`:tL- 'rsPROPERT.Y, DESCRIPTION.••.- ra`'' ?_Fi4^!'- ?�.5' -``-i : County Township Lesser of 12 Homestead T - district (a. town, to nship) Township ©Parcel number Legal descriptio -7.,�a �� Is the pmpe in question: eal property ❑ Mobile Homo (I.C. 6-1.1 -7) If any portion at the residential structure or the land not exceeding of the property ufil¢ed b produce income. ne (1) acre met immediately wrrounds that stru re is used b produce income. describe the use and Portion � �V7 .F �"•t i� =i' ♦ -ems '.. s .. • . j PROP. ERT. YOWNEDrBY- CUUMANF:IN[OTHER:COUNTIES'' . _.. ..* - Y•i' i� P Tv i «.s. ' Yi ' __.. Lesser of 12 Homestead County Township County Township I hereby certify the above statements are true, correct and complete. SignatT o aim t Address (number and et, city, stale, P ) � v F`7 • t�.yVl1LlJE.- ` RUES`TAX ;'�A.43ESSED�IN11E. .HOMESTEOOly"`:.rN" ON ESI�ENTIAL •i -'^ J µSR�r�UyTSEONLY,'/�q , £t •�$. 'r iv�2 ✓�5� %vCY�1 . '.'AT =100°.b'OFT7V :.'Wiv- ..��n.Y• VALUE r•$ 1 "•n > , t.l.ik3VALUE 4.��i j -•�.I, t,i�ra.�tli VLF Land not exceeding 1 (one) acre immediately surrounding residential improvements. �z•),- Other land (2)" `?fi%i n Yf Total land (line 1 plus line 2) (3) Dwelling (4) Residential Improvements or Annually - Asaeased Mobile I Ma tufactured Home Garage (5) �- �1� ,`�-= Other improvements (6) t.i ' -;S"•r Tdal improvements (line 4 through line 6) (T) Total value (line 3 plus line n (6) I hereby certify the above is We, correct, and Signaure of Assessor Date signed complete. verifying action - Signature of Auditor Date signed <- -eye —'R.•" ��- y§,�tf - "- Nircr`x'" • :."3i. ����3'i {`,o?�.i!.yS)xtz a. fcr fi' �<. 5�.- �.., 3�.STANDARD'OE000TION'ALLOWIWCE > .�.'- ;._.:ice. ra�wu�f1 ,- - -.... •1,- i.c�r`= a✓�>.� ,. - 20 _ Pay 20 _ Lesser of 12 Homestead TS valuation or 535.000 Signature of Audito Date signed • slATE FORM`)•M,R_Ioln TRfAsu.ER FORM TS-IA .AFFROVEO MY SflTL BOARD OfA("e rat.aiM FFf]YAlam BY nn:DrPARTEVf OF LOCAL rovrR`1Mrnl FEASCE rct.l.l-r-r.l 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 in hills for all:therefore. ® HEA 1344-2009 requires taspayem who receive the homestead standard deduction to verify that they arc eligible to receive the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead filings.This information will he kept confidential and can only be accessed by authorized county officials.The Depannent 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 Property Address Lambert, Charles Dale/Debra Ann 104 S Campbell BLVD Hauhstadt IN 47639 2721 Charles D Lambert 104 S Campbell Blvd State Parcel Number Legal Description HAUBSTADT IN 47639-8162 26-18-36-403-000.583-009 013-00583-00 WEST HEIGHTS 3RD ADDN Itieellutelollitteliellittlutleteillt111111111111m11111111111 304 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 Middle Last _ I _ its is A IA Y L g Address(number and street,city,state,and ZIP code) Same as property address I O L( C tl-r►_p/z t t�. If /I co.St,�-t r- ztva Li 0 639 Spmue ' - "-' irst Middle Last p E a R t A. [\ 64 hil3 F 12t Mailing Address(Number and street,city,state,and ZIP code) [me as property address �b(� S , l' • mn[�&let lf�kPcf p7` .N u0L37 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