Homestead_Lewis (11) 514TE FORM!Mt.'IC/WO nhFAWEA P0104.73-M
ArrNP'ED BY flat B MJD Of N[TS.Nrt._`an PEE][AmfD BY Tilt DEPART\ff4TOE LOCAL GOVERNMENT FINANCE MV I.I-t-si
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRIN N 670-c Individuals and married couples are limited to one homestead standaid deduction.As the receipt or this deduction becomes
yy more beneficial.there is more incentive titan eter for homestead fraud.homestead fraud causes higher tat bills for all:therefore.
S _q.1 HEA 1344-2000 requires taxpayers who retch e the homestead standard deduction to verity'that they are eligible to receive the
benefit and to provide additional identifying infornutwn necessary to allow county government to better monitor homestead
APR 1 2 7 u Ise filing.This information will be kepi confidential and can only be accessed by authorized county officials.The lkparmrnt of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
.O't aG Taxpayer Name Property Address
GIBBON COUNTY AUDITOR Lewis, Darla Jean
706 li Vine
Fort Branch IN 47648
2892
Dada Jean Lewis
706 E Vine State Parcel Number Legal Description
Fort Branch IN 47648-1228
�r�rt��tt r�t��ttt�tt��t t�t tit��It�t�tt�t��tt�t��tttr��rrtr�t�� 26-19-18-304-000.451-026/, 011-00451-00 HILLCREST 67PT
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.
Spouse First Middle Last
eail
Laos-
Mailing Address(Number and street,city,state,and ZIP code) ri Same as property address
7o , ,e. ✓,1�� `fir ,7: 4fenstE/ 7L 91'
- - ---- ---- --- -- --�.___�— - -- -
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.
-
FORM HC 10 1979
Preuribe0 By State BwrE oi Tax Commi55ioners
To & FiIM in DuD���e
CLAIM FOR HOMESTEAD PAOPEflTY TAX CREUIT FOR YEAA 19 79
:�s.�:��
�(We) �-e�� ,� �'+'�+
of residenc the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned _ D /( � �� ` �/ '��
❑ are buying under contract
❑ have a beneficial int rest in the taxpayer
Property Description in -��-l+'� �C/ounty ��L�� �� Township
Taxing District (G1tq;-Town, Towaship): c�'f •� �Za�e-�-- �
Parcel Number or legal desc�iption shown on tax statement:
7.L�� � 7 P.¢,
If buying on contract: Owners name ��� simo�e owner�
Contract recorded in Recorders Office - Record No. Page
If any portion of the residential structure or the land, noi exceeding one (1) acre that immediately surrounds that
structure is used to produce income, describe the use and portion of the property utilized to produce income
Any other counties in which individual owns or is buying real property: County Township
hereby certify the above statement is true, correct and complete.
�
naa.ess
y�
Ciry. Sute ana Zip Cooe
Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
True Cash
Value
Lan n. ex edin (o acre immediately
s �� un�ng �en� improvements (�) �/ o0
Otfi�r Land � .p-�9 (2) "—
Total Lan'ti14� 3� '� `�
Residential Im ov ents
�, ' p�D1?OR
Dwelling
Garage
Total
Other Improvements
Tc�lmprovements - Line (6) plus (7) equals (8)
I h� eby certify the above is true. correct. and complete.
Signamre ol nsusso�
(3) / / o 0
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- ACTION BY AUDITOR -
Assessed
Valuation
3 �o
�/�j���jj
�/%�� o i/o
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Homestead
Valuation
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5�23 �79
Date `
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