Homestead_Lewis (8) HATE FORM.!M 12r',AK) IWASURFA(O&M TS-IA
MPRr'ET BY ST 1L&kVmnf AMOUNT!,:on PVANBED BY fir DFPMh6Yi OE LOCAL COVER-WENT FINA\CE M41.1-::4.I
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 e'er for homestead fraud.Homestead fraud causes higher tax bills for all:therefore.
• HEA 134-1-2000 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 go'emttart to better monitor homestead
filing:::This information will be kept confidential and can only he accessed by authorized county officials.The Depaanntent of
Local Government Finance will toe this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Lewis, David M/Gayle M
206 S Willard
_ Eon Branch IN 47648
2854
David M Lewis
206 S Willard State Parcel Number Legal Description
FORT BRANCH IN 47648-1439
26-19-18-303-000.225-02 /011-00225-OO EASTVIEW 26 IIInIIntI Ian I Ilnlun11 I 1n1ltltlnlluullttlrtitl
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
'nu Address(number and street,city,state,and ZIP code) areas prperry address
Z 0 S . GJVcrd s/ -17, 1G.,)< 4 a v76
. _
Spouse / A// /First Middle Last
Mailing Address(Number and street,city,state,a nd ZIP code) 2-Same as property address•
ER c&& S . c<.) r.I t o. rd S 1- r 3 ro..t,-,d-,, 1 ti (-1-7(e`q
-- - - --`_- --_--- - - .
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
.P
ie. ...,,
CLAIM FOR HOMESTEAD PROPERTY TAX
� `� CREDIT/STANDARD DEDUCTION
i�
's• : �'
State Porm Y173 (R2! 5�92)
INSTRUCTIONS: See reverse side (or filing instructions.
n
. - . . � � �� rFanc�cen
,FORM.. . YEAR
/ ��iHC10iL :(L li � 39i`J ..�
_y��,�
' � ' ,J
6661 � � l�p
:,-�+� - - _ � - � - .
..o ' � j
I(We) �- G� --.. . .. -. .-.. .�: .•�.. � certify thai i n.t e 1 st day of fMarGi�f 1I9
n r�.—
I(We) occupied as our pri ipal place of reside e he following tlescribed real property tor which a Homestead Property Tax CreGit is heretiy daimed:
�I (We) owned ❑ Are buying under contract
Have a beneficial interest in the entiry tfiat is liable tor the property taxes on Ihe property and that owns [he property or is buying under a contract.
- . � �. . _ . -0ONTRACT RECORDED -,- _. - s.. - � .• c.•�.: .
Ii buying on contrect. Fee Simple owner's name
Recortlefs office where contract is recorded _ Recortl number Page
County
� � - PROPEH'TY DESCRIPTION " � � - � �� - �
Township Taxing distri�city, town. fownship)n
Parcel number Legal description
o�l - bb�S�
If any POrtion ot Ne residential struMUre or Ne tand noi exce2tl
of ihe property utilized to produce inmme.
VROPEHT'/
Township
aae that immediatey sunourWS that struciure is used to produce income, descnbe ihe use and ponion
I hereby cenify the above statemenis are true, correct and complete.
��eu (number arM streei, pry. sta(e. ZIP code) �
BY CLAIMANT IN OTHER COUNTIES
Township
ASSESSOR USE ONLY �UE TAl( ' ASSESSED HOMESTEAD - NON-RESIDENiIAL.
� VALUE� VALUE VALUE VALUE
Land not exceeding 1(one) acre immediately � . ���
surrounding residential improvements. (�) - -
Otherland (Z)
7otat land (line 1 plus line Z� �3)
Dwelling (4) � � - � �
Residential improvements
Gara9e (5) � �. .
Other improvements (6) �
Total improvemenis (line 4 through lina � (7)
Total value (line 3 p6s line � (g)
I hereby tertify ihe above is lrUe, correct, and Signamre of Assessor Date signed
complete.
Venfyirg action - Sgnature of Autlitor Date sgned
� STANDARDDEDUCTIONALLOWAt10E°" -� -
79_Pay 79_
Lesser of 1/2 Homestead
Valuation or $2,000 �
Sgnature ot Autlimr � Date signed_