HomeMy WebLinkAboutHomestead_Lewis (14) VOTE FORM OVA MEASURER FORM 11-1A
.VFW'EO bi LINE MSARDOf ArroUSE 9v PPI:YWPEDfl OW DEP.ARflC4 Q LOCAL a)S£RYMENT rn:AVCE MH.I_4.0
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead Slandant deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than e'er for homestead fraud.Ilonresteal fraud causes higher tax bills for all:therefore.
HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verily that they are eligible to recei'e the
benefit and to provide additional identifying information necesetry ro allow county government to better monitor homestead
filing,.This information will be kept confidential and can only he accessed by authorized county officials.The Ilepanmen of
Local Government Finance will use this information to create deals that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Lewis, Charles R
1004 S Center
Fort Hmnch IN 47648
2957
Charles R Lewis
1004 S Center State Parcel Number Legal Description
FORT BRANCH IN 47648-1708
J.lu11u.lill.u1n11u1tnt1�l.u�1hntlultllnu1u1rr it ll 26-19-19-103-000.096-026 011-00096-00 LOWES ADD 7P178PT
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
C\e.C1-c\ es Ri(-z\f LeLa;s
Address(number and street,city,state,and ZIP code) {� D-8fme as property address
`bo J S . AWN.*t r Lam.* . O't � `JV'o.NnJ k-1-1 La \��
Spouse First Middle Last
v.,, er\Y I\ v".. Le. LS(S
Mailing Address(Number and street,city,state,and ZIP code) L SaI1e as property address
\Doy S. C.R.,/.�es- Si . Lik%
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 sere /) Date
•
G
"'" CLAIM FOR HOMESTEAD PROPERTY TAX
g ._ STANDARD / SUPPLEMENTAL DEDUCTION
State Form 5473 (Ri2 / 6-09)
+�' � Prescribe0 by �he Depariment of Local Govemment Fi�nce
INSTRUCTIONS: See reverse side !or filing insfnicfions.
FORM YEAR
HC10
�-aa-o`f
•
I(We) ceNfy ihat 1(we) ocwpied as my (ourj princtipal
place of re � ence or am (are) buying the following described real propery (or which a Homestead.Pmpeny Tax Standard Deduction is hereby daimed
unde nVact on ihe date this applinGon is filed, (date of filing):
I(We) own ❑ Am (are) buying under recorded contract
❑ Am (are) entltled lo oceupy as a tenant-stockholder of a cooperative housing wrpora[ion
� Have a beneficial interest in ihe Irust or [he righ� to occupy the pmperty under Ne tertns of a qualified personal residence irust
•• . •
N tlainWnt(ICgalname
Sotial Seamty nw� of uriant (qsf fne d'gds) Orivefs license I Identifiralion / Olher Issuing State
ol tlaiman� (last frve dgiGtJ
Name of
Sodal Seanry numbu ot tlaimanCs spouse (last five tligds) Drivers license / Identificatian / Other mimber Issuing State
of damanPs spouse (las( trve d'yils) �
• ••� �
I� bying om m�tract Fee Simple owneh rame
Recoidefs office where contrad is recorded Record number Page
. . � • • � • �
Counry I Township Taring disiriU (rily, town, townshiP)
ber M LegaldesaiP�n IslheP�P�Y�W��: '
6' �'� _ D �OW' ❑ Real pmperty ❑ MnuaDy assessed mobile home (IC Gf. t-n
tl any portiw� of Ne 2siden;ial swcture w ihe land not exrPedug orre (1) aue that immediatety surtaunds ihat swcNre is used to pmdum income, desaiha Ne use anE portion
� of Ne pmperry �mT¢etl m poEUCe inmme. � V v`/ `� � {� I� 1
I �� �
r-
•.• . .: . .
Caumy TownshiD CoumY Tmm4up
I hereby certify the above statemenu are we, covect and complete. aw of d.mam �
Addreu (number antl stree; a1}; s1a;e, and LP wde)
� • • � • �
�� � ii'. •
land not eaceeding t(one) acre immediatety � �7=,:eftr �;.�"'x..Hv,'N �„^Y f rY .� �`
surroundin rnsldential im rovements. � � . � -s�-�
�y ���u.;''`x ,
Otherland (2) ' :°��u.�`�':�`
f:
Total land (line 1 plus line 2) (3)
.ti,� h ./ S- ,+"d--. �'Ci:T
ResieenUalimorovementsorMnualty �Ilin9 (4) �X���.?��},�r �'�„�-y:
Assessed Mohile I Manufactured Home � 3 G�- '�'y � zr""�,
Garage (5) .-S�ti 'n.�'�� r�r4 's<'v�!.
`F^�'.^:,cd"E ��•4h?.=y„
Other improvemenis (6) „* � _, ;,s„ ;._z.
7ota1 improvements (line I thmugh line 6j (7)
Total value (line 3 pl�s line n (B)
1 hereby certify ihe above is true, cortect, Sigrawra atAUessor � Date signetl (monfi, day, year)
and complete.
Vaitying acUon - 579nawre of PLdtw Date signed (month. daY. Y�)
�.-� � � � •
20 pay 20 Lesser of 60% oi Ihe assessed vatue of the homestead or 545,000
lJolwi7hslaMirg any otherP���. �e sum Nthe Ceduclions proWed in IC 67. f-17 to a mobde fame ihaf is g
mt assessed es real property w to a menutaUUred home fhat is rot essessed as ieal properry may not erceed
onehafl(1/1) W Ne assesscd rafue o/ the mobde horne w manNactured home.
S5nature N Pudiln Date signeC (monN, Oay,1'sar�