Homestead_Lynch (2)} CLAIM FOR HOMESTEAD PROPERTY TAX FORM
YEAR
CREDIT /STANDARD DEDUCTION HC10
State Forth 5473 (R614-03)
Prescribed by the Department of Local Government Finance
INSTRUCTIONS: See reverse side for filing instructions.
UC
I (We) a G certify that on the 1st day6of 9903 20
1 (We) occupied as our principal place of residence the following scribed real property for which a Homestead erty Tax Cre it is h- reby claimed:
❑ I (We) owned ❑ Are buying under contract
GIBSON gt M0
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or tsCbaymgTdhdettd Mra
'. tort: €L:t x,•,.. "`s - ,,��`" i „,' -�,k i ONTRACT,.RECORDED's =` - - '°, 3- •"-''t '3 `- ,'�'= .
If buying on contract, Fee Simple owners name
Recorder's office where contract is recorded Record number Page
��'
VCoun
-
P,ROPERTY,DESC IPTION �Z .x�?i"?�'y�.+'�7Lrs�.a�..,
Toomship
/� I Twmship
vN
T distri (d town, t ip)' /
�� L�
Pa num/¢�er
(t/ / k/ -
Legal description
agi � _ L
I� J
Is the pro perty in question:
Real DroParty ❑ Mobile Homo ( /.C. 6-1.1 -7)
H any portion of the residential structure or the land not exceeding one (1) ace that immediately surrounds that structure is used to produce income. describe the use and portion
of the property utilized to produce income.
Land not exceeding 1 (one) acre immediately
, -'� - C 9/-- .3oQ- o6�.,3sZ'q
?a"."h,"".7- -' ;°- en�i'"_ °r`'�zu; � PROPERTYi6WNE6iB CaI AAA- NTINiOTHER`COUNTIES`, �k N ss2:
County
Toomship
County
nship
I hereby certify the above statements are We, correct and complete.
Signature c imant
I� J
Address (pu and street, city( tie, ZlP code Amt / 7
_ 4,
i = °ASSESSOR�USE ONLY' A'r
3RUE TAX
�SSESSEDVALUE.HOMESTEADr
NO_N?RESIDENTIAL h
3r ,_ ,�, tgo-:s,. - n.,
VALUE-
AT�700%OFT,TV,VAIUE,.v
oa 4u. `a.V/1L.UE.- .a:3ia
Land not exceeding 1 (one) acre immediately
;r ' ”' -W
surrounding residential improvements.
(1)`
=Y"••?3
Other land
l2i
(2)
-'-
Z..M",
Total land (line 1 plus line 2)
(3)
Dwelling
(4)
KIM s
-Yt
Residential improvements or Annually
Assessed Mobile I Manufapured Home
Garage
Mai l 2 u�'Si
(5)
Other improvements
(6)
Total improvements (fine 4 through line 6)
(7)
Total value (line 3 plus line 7)
(6)
1 hereby certify the above is We, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
`' IMru .s�!20 _w Pa4°• -I�' �STANDARUbEDUCTION 'ALCOWANCE?S.r�.;,�s rs" � %w' ' x "`s.'w"'.. ,`�'i + r <± ., a
20_Pay 20_
Lesser of 112 Homestead
vauatfon or E35.000
5
Signature of Auditor Date signed
STATE roRN Vw ia_/,..rvl UzASZLIA rOAN:}IA
APPROVED rIMPORTANT NOTICE TO DEPARTNEW OF LOCAL
OPERTY0.OWNERS
Gibson County Auditor
101 N Main
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
mote beneficial,there is more incentive than es er for homestead fraud.Homestead fraud causes higher tae bills for all;therefore.
0 HEA 1343-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to teethe the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The D epanment 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
Lynch, Steven UDebbie S
R I Box 55 B n
Patoka IN 47666 1
67 1X\
Steven L Lynch
1481 W 550 N State Parcel Number Legal Description
PATOKA IN 47666-9053 t
I t�trlltr tlt llt ttllrttllttlrlt rllrtttit lt rtllrlttltttt11t1t1t1 26-04-12-300-002.348-018 010-02348-00 PT W 12-1-111.91 AC
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 1 First Middle Last
5fephen L. . 1-yiict�
�ng Address(number and street,city,state,and ZIP code) Same as property address
jt Sj W 5s0 Al
Spouse First Middle Last
Dada. 6. Lys C )
Mailing Address(Number and street,city,state,and ZIP code) 0 Same as propene address
14S 1 W 6-SD Al
- -
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 Signs ry J Date
PART 4:ADDITIONAL INFORMATION
