Homestead_Lane suiE mRN�j Irr/Vw, TREASURER FORM 7.3-IA
APPROVED BY pUEYWtn OF At CIA(NA&l,m PrLxRUBED BY PIE DEPARTMENT OF LOCAL roarxSrIa FINANCE tCH.1--4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD 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 eser for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
HEA l344-2011q requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to receive the
benefit and to provide additional identifvine information necessary to allow county government to better monitor homestead
filings.This information will he kepi confidential and can only be accessed h.authorized county officials.The Department of
Local Goverment Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Lane, Jerry D/Suzanne
Rr 2 Box 178
c IN 47648
7940
Jerry D Lane
7668 SUS Hwy 41 State Parcel Number Legal Description
FORT BRANCH IN 47648-8407
III I I I I I I I I I I I III I I I I I 26-19-19-200-001.222-026 007-00455-00 PT S N NE 19 310 9.074 AC
r n nt t ton n r n n u nt rot u n r rr t // D-27
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
Ong Address(number and sum.city,state,and ZIP code) Same as property address
\
\ J\V -\� C1 a — —.�� ‘41\
Spouse First Middle Last
Ex
Mailing Address(Number and street,city,state,and ZIP code) ® as property address
_
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.
aa____Owner I Signature Date
•
, CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
� ,I �,, Slate Porm 5373 (R6I403;
Prescnbed by Ne Depanmem d Local Govemmeni Finana
INSTRUCTIONS: See revcrsc sidc !or lilinq inslrur,lious.
FORM �, YEAR
HC10 �
c"{..;— it.:ij; .-t � o..' . `.••••, •. .� . . CERTiF A NSTATEMENT"� � -. .. . - - " .
I(We) certiy that on the 1 st day of March, 20_
�I(V/Je) occupie as ur princi a place of eside ce t e following described real property for which a Homestead Property Tac Credit is hereby daimed:
L�I I(VJe) owned ❑ e buying under wntract
� Have a benefidal interest in ihe entiry that is liable for the pmperty taxes on ihe property and that ovms the property or is buying under a contract.
I( huying on contrad, Fee Simple owners name
Retordefs ofice where wntraq is recorded
MAR
Rewra number
:=�=�� �-:.�. +.^_ "- � ��-�'.'�' . .Y:'"�=_�' ,'=BROPERTYOESCRIFTION�';"' .:..... ' u��50N:GOUN7Y q "- - -. .
County Twvnship Tanng di5l' �ry owq rownship)
m r � al description Is e properry in question:
� eaI pro0erty ❑ Mobde Homo Q.C. bf.f-7)
If any potlion ot the resiAenGal sirucwre w the Wnd not excaeding one (1) acre that immediately surtounds that sWCtura is usad to produce inwme, desUibe ihe use antl portion
of ihe property utilized ro produce inwme.
� / 7 / / '/7fLJF/ r
Counry
I hereby certify the above statements are true, correct and wmplete.
Atltlress (numbe� and Stre�[, city, sfate, Z/P tode) _ _
"""�� i r+ ` `TRUETAX ASS
q;����x�rt � �ASSESSDRUSE�ON Y� -. '---VALUE � - A7
'Land not exceeding 1(one) aue immediatety
surrounding residential improvements. (� �
Otherland (2)
Total land (line 7 plus line 2) (3�
Dwelling (4)
Residentiel improvements orMnually
l�ssessed Mobile I Manufachned Home Garege �5�
Other�improvements (6)
TUaI improvemenfs (line 4 fhrough line 6) (7) �
T�tal value (line 3 phs line n (g�
I hereby cetlify Ihe above is We, conecl, and sgnawre otnssessor
complete. �
Verifying action - SignaWre of AuOitor
20 _ Pay 20 _
lesser oi 1r2 Homestead
va�uanoy or 535.000 �
SgnaWre of Auditor
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imant
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Oate signed
Date signed
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