HomeMy WebLinkAboutHomestead_Lewis (10) •
— , STATE FORM 53569(RS/&IO) TRFA54RFA FORM TS-IA
APPROVED DV STATE BOARL OF 9KOONTS399 PRESCRIBED BY 771E DFPARMRNT OF LOCAL COVEXNMEYTHNAN(E IC 6-1.1-22-I I
Gibson County Auditor IilIPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction. As the receipt of this deduction becomes
•Princeton,IN 47670 more beneficial,there is more incentive than ever for homestead fraud-Homestead fraud causes higher tax bills for all;therefore.
FILED HFA 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 I nnstead fraud.
APR 2 9 2011 PART I: PROPERTY INFORMATION
•
Taxpayer Name Location Address
C. . `
v Lewis, Peter J/Melessa
—.
. GIBSON COUNTY AUDITOR 600 Tette Park DR
Fort Branch IN 47648 - .
2439
Peter JLews 1101[III.01110IIIDD11IDllUhi[liii III01011111_II_iiiiI11111011011010111111
600 Tretter Park Dr
FORT BRANCH IN 47648-1220
11111111411111111111111114111111111111111111111111111111111'I'IIll�lll'I'l�llllll�l�lllFl�llFll State Parcel Number Legal Description
26-19-18-301-000.265-026/TRETTER PARK 3
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.
•
14) PART 2:TAXPAYER INFORMATION
First Middle last
? er C a API L e s
Mailing Address(number and street,city,state,and ZIP code) -Same as propeny address
,cob Tre*!cr Po. k Dr. ✓ 1-01-4 IJranc4 , J-N 117(48
.
Spouse , First Middle - Last
Me%ssa cCLTC L. ewf s
- Mailing Address(Number atidsnee4 city.statanatldZIP ccede)--�//`� -—, — --__-- _grant. _ _1--1 Sarno as property address — _. —
6 0 0 Tr^e tf er l r l� 4. rr7 r 7<- LL( °'X4) et 76 q� .
Each undersigned certifies,under penalty of perjury,that the above and foregoing information is true and correct and that he or sheds 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 - , n Date
� � CLAIM�FOR.HOMESTEAD PROPERTYTAX
� � � CREDIT/STANDARD DEDUCTION
t�M State Fam 5473 (R6 / 4-03)
' Prescribed by Ne DepartrneM of Local Govamment Finance
� INSTRUCTIONS: See reverse side Por filing instnnctions.
FORM Y�R
HC10
tr-,�. .�t�,��-,w,�_�._r>,...r��-.s�w'.z.«.,.s- �..�,. ��..�.,,� m���:,:: ,.- ...s» �.-; �-Y. -.s'..> --
I(VJe) certify that on the 1st day otMemh, 20_
I(We) occupied es our pri 'pal place oi residence Ne tollovnng described real property for which a Homestead Property T�c Credit is hereby daimed:
�I (We) ownad ❑ Fve buying under contract
Have e benefidal interest in the entiry that is liable for Ne properry taxes on the property and ihat owns Ne property or is buying undar a conVacl.
If buying on contreq, Fae Simple owners name
Recordele oftice where contraq is recorded
Counry Tovnship
Parcel numbm Le 1 descnption /�
- Y
I1 eny portion of the resitlenUal sUUCtura u the WM not exceeding one (1)
M Ne proporty utlitred m produce incame.
T�ing
number �Pepe
Is iha pmpeRy in Quesdon:
�eal pmperty ❑ Mobile Home (I.C. 67J��
surtounds Nat cture is used to produce income, dascriba tha use and porlion
- ' _ -.e.
� a':'."^'�r'-.s �?a;c-..i���*°�r.��`�`.'��}.. "'��'�+.-;�PROP,EFIT,Y.OWNED'BY;CLAIMANT.IN'OTHER'COUNTIES`Y-c��wi`i-_'�e^o�, '�f ;y`�"�_ ���: �x';�;
.�-_
County Tvxnship Caunty Twvnship
I hereby certify the above stetements are We, correct and complete. Signanre of deimam
ress (number arrd street, ciry, stare. Z�P code)
� � "�� '��'i -��''�''�V� l��� �'=' � '' e;�t�TRUE TAX�h� `� �ASSESSED VALUE HOMESTEAD � ? ` °C ' - t'
'P:.�:`.'kr,�e'��..�E9S���s�n'�<kY�;. ��J�' �'4 .� .t�i.,_ : r $. � .�2.:A,�'tNON• VALUENTWL
''3'sY-,.� � �.y'<;, -yc?�c^VALUE�i,� . AT,;100°/.OFTTV a •tVALUE�''� .i �i_.. ._ _^�`..�.s�`, ..
Lend not exceeding t (one) acre�immediatety ( � ;,•" }� 4�. ? ��`.�- :.,.,FL Y ; Tr �
1 :�� c �.�t 1 . � �
surrounding ras(daotial Improvaments. ti,,.. ,;,,,, ��r.,�,.__P,�
Otherland �Z� - _ ".;-
- :.f"=:-`�i� ..
Taal land (Ilne 1 plus line 2) �3�
rv� `,.;. '�e � � .i
ResidenGal impmvements or Annually �11109 (4� �� �- � � � -'C '
Assessed Mobile / Manufactured Hwne ;. � �
Garege �g� _. s.4.'� , x:� �'"� �'. �;i
,`.h 5: Y.' o G+ r
.O�herimprovemenis (6) - _ =''r��'�';
Tctal improvements (line 4 fhrough li�re 6) �7�
Tdal value (line 3 pl�s Ifne � (g�
I hereby certify the above is We, cortect and � 5ignaNre of nssessor Dau siened
complete. �
Verilying ection - Sipnature of Auditw Date signed
� �'.``r4.;�T�:?a�.-`S+,ri �'�T�i�.�`���_�.+�.+.e"'er�:3�':STANDARO��UEDUCTION`ALIOWAMCE.�.. �.'ex4.. _ .�,"...' - -
20 _ Pay 20 _
Lesser of 12 Homestead
Valuatirn w 535,000 S
SlpnaNre oiPuditor Data si ned
9
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