Homestead_Lynch S WNE FORM.UMSIA2 r EMI MEASLIER FORM TS1A
.AIIBm'EII BY STSTE IMND OFAfl YR..STS.!aM PRISMBm BY n6 DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC 6-I.1224.1
Gibson County Auditor .101 NMain ==—IMPORTANYNOTICETO-HONIESTEAD"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 ever for homestead nd fraud_Homestead fraud causes higher tax bills for all;therefore.
1111 • HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to recent the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filinpn.This information will be kepi confidential and can only be accessed by authorized county officials.The Dcpannrem 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 PropertN Address
Lynch, Luther L/Betty Ann
R I Box 55
Patoka IN 47666
2090
Luther L/ Betty Ann Lynch
5518 N 150 W State Parcel Number Legal Description
Patoka IN 47666-9052
�t�ur��rtt�t��t tt��ttt��tr�t�tt��tttt�r�t tt�t�tt t���r r�rr��r r� 26-04-12-100-000.567-018 010-00567-00 PT W 12-1-11 87.85 AC
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
/V/V [y/i/C-
•tg Address(number end street.city. and ZIP codej- .__ 0 Same as prepc4=ddre s -- - - -
-C37/4/4C-6 w . P4 7-64)4 - `/V V71
Spouse First Middle Last
t
Mailing Address(Number and street,city,state,and ZIP code) Same as property address
Social Securiy Number(last 5 digits) Driver's License/State ID Number oast 5 digits) Other(please specify in Pan 4 below)
sae
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
ems' a CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
CREDIT /STANDARD DEDUCTION �j 1
State Form 5473 (R2 / 5 -92) F
rsi. - 2 Iby�
INSTRUCTIONS: See reverse side for tiling instructions. 3 R
CE FlCATION STATEMENT
I. (We):'� c n y: tHat on the 1 si day of March, 19
occupied as our principagace of residence the following de #bed real property for which a Homestead Property Tax Credit is hereby claimed:
03 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 or is buying under a contract.
CONTRACT RECORDED
It buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
- PROPERTY DESCRIPTION -
County Township Taxing district city, town, township) r .
Parcel umber Legal description '
S 0 -00 1 J - -
It any 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.
o�� -O`��— Off— �a- 4D0• ✓�•7-dld"
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES - -
County
Township
County
Township
®eby certify the above statements are true, correct and complete.
Si natur claimant
�J
Address (number and street, city. state. ZIP code)
/N.
ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding I (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2)
Total land (line t plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
- -
Other improvements
(6)
Total improvements (line 4 through line 6))
(7)
Total value (line 3 ptus line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor .
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or $2,000 $