HomeMy WebLinkAboutHomestead_Lewis (9) STATE FORM 51569(N15-10) TREASURER FORM TS-IA
APPROVED BYETATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-I.l:L5.1
IMPORTANT NOTICE TO HOMESTEAD:PROPERTY OWNERS >� ,
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
',Auction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
causes higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
standard deduction to verify that they are eligible to receive 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 Department of Local
Government Finance will use this information to create tools that will help county officials eliminate -
homestead fraud.
' PARTI PROPERTY INFORMATION
Taxpayer Name pronrnv Adders{ State Parcel Number I peal Descrintion:
Jeffrey A Lewis 107 E POPLAR ST 26-18-24-204-000.090-026 MCCRARY ETAL 107PT
FT BRANCH IN 47648
fonralete and return to: I.?nllnuli1nn niERP,j nJInlllm0]I1n if711II
IIWIIW 1111 NYDLYNY JY Ul 4i Yi uv uan.-uu uiw
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
•
' PART 2:TAXPAYER INFORMATION
Owner 1 First Middle Last
(Fe FFre /9/,n-/v L ew i s
Mailing Address(number and street city.state and ZIP FA-re! i
T 5ame as property address
/9 r PO,/nr ST F71. Cr.9 NC x v 2 re-
•
Spouse First - Msddle Last
iMelA Ir L ou /Se Gc&&&is
Mailing Address(comber and street city,state and ZIP code) vii Same as property address
/0 7 c - fo,0//ef ' ST- - 6r/9tic /
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.
- 1 ,t' e VIC& y Date �
NOV 1 t
GIBSON COUNT"
CLAIM FOR HOMESTEAD PROPERN TAX �
CREDITJSTANDARD DEDUCTION
t Siata Fortn Se73 (R6 / 4-03)
Presaibed by Ne Department of Loral Govemment Finance
INSTRUCTiONS: See 2verse side for (ling inshuctions.
�O^R•M YEA �
� � ��J��
MAR 2 3 2007
� ��5:+_.i �C� -��J. ��YCRIIrIMN11U1Y JIMICMCIYI • •.�Z'"�' - �/2��� �? � �jy��'
�.�e) . ._. �� . ` �yt��iTmE75tYdayoiMarch, 20_
1(VJe) occ ied pri i al place of residence the following described real roperty for which a Homestead Property T�c Credit is hereby daimed:
❑ I(We) owned fve buying under wntract
� Have a benefidal interest in the enliry that is liable for ihe property taxes on the property and that owns the property or is buying under a conVact.
If 6uying om m�traG, fee Simple owners name
Remrdels olfice whera canVact is recorded
County
Parcel number
K[�-/ Zf 'G Y - �O C�,�
It any portion ol the residential
of Ihe property utilaed to prod�
O lI -G� 90- ce
County
Tamship
Legaldescription ��
�,�'7J.�� ��O! �G � /l.Q
sWCtura w the land not exceeding one (1 � acre tnat
ice income.
Tavnship
I hereby certify the above statemen[s are We, corred and complele.
,adress (number arM streef, city, stafe, Z�/ code)
/ D! F- ��o /.9/' �. �Q''�uG �i
7acing district (ury, fown,
Is the
surtounds that
y 7E %�
Record number � Page
al-bropeM ❑ Mobile Homo (I.C. 6f.7-))
is used b Droduce income, describe Ihe use anA portion
��"�+�"��� ' �'"i°i +�_'� b`7RUE.TAX� ASSESSEDVALUE t+HOMESTEADi NON=RESIUENTIAL '�
S��:i.'�.'v`!z�"p� ESSORU SE ONLY -: _�{3£�a� � VAUIE-�".°f.`z. -r 11T t00Yo'OFT7V ,�. �VALl1En `' *�+t v- .t.: �• -:e�
.1 ac.Y-,.-. ...-5'� ��c�. VALUE�s.,�,��•-
Land not exceeding 1(one) acre immediately (� � h 4 �4�.�; �� wi. �`�� �
surtounding residenUal improvemenls. . .+y�^t' , � �?�3�5'',�r �n.,
Other land �Z) �; �� ;�;� �� Y
.� ��'�r -.�
Tdal land (line 7 plus line 2) (3� .
. ' �.i l r.� sf :`.
<y'��y't25r�"�,�'i�.r•- yn.t
Dwelling (4) �.., �u� :����r�
�Residential improvements or Mnually - '°��`���
Assessed Mobile / Manufactured Home Garage (5) �� �c�,y.�`'`���'� ��.� 9� �
`:`�'Nn�".+'.�',��-�.:�•��<3�:
..-c.,r:_ �:
Otherimprovements (6) : �;+'i>"""�=s'�
'.-.: .;..�-�*,"-':s� •��'
Tdal improvements (line 4 throuqh line 6) (�)
Tctal value (line 3 phs line n (g)
I hereby certify the above is We, correU, and SgnaWre ofnssessor Date signed
complete.
Veri(ying aclion - SignaWre oflwtlimr Date signed
��-�"-.``'�.i ���r ..�r���<� �:��:ds�`�:��'''i�STANDAR�;DEDUCTION ALLOWANCE t i Y.`-'�.'�uAt�.4�Yi�.'3`•��nn-s-s��iS�����, ��'-.::
20 _ Pay 20 _
Lesser of t!2 Homes;ead
vaWauon a $35.000 � '
Signature o1P�uditar ' Date signed
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