Homestead_Luebbehusen (3) STATE rni,53'N IR:/YNI
APPROVED BY xrxrl WNW OF M JNs.:nrr PRU.[lJnlW BY nit DEPMfW:Yt fK L•'AL rwwrcR.`MFATE ME I.I-::-t.l
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead slander('deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud.I lomesread fraud causes higher tax bills for all:therefore.
.• HEA 1344-3019 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. Ibis information will he kept confidential and can only he arressed by authorized county officials.'the Department of
Local Government Finance will we this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Luebbehusen, Mary Lee r, ,(�
R2 Box 119 �i / /�\W/
Haubstadf IN 47639 p� `
10998 \ U Up1�J Q/
Mary Lee Luebbehusen �`f
1854E Warrenton Rd State Parcel Number Legal Description
Haubstadt IN 47639-7945
26-23-16-100-000.653-024 004-00653-00 WARRENTON 34/35/53
t o II t II nn II t I e I n I ur IIr I rat I n Ir It I u I t I n I u II rat I I
" PT/56 PT
Spouse First Middle e l -Q(2 l/-`e-QJ A Last
Mailing A ress(N ber and sued,city,state,and ZIP code) ❑ Same as property address .111�M
S i £r F LOcuustrfrn , Pci, N , ftJtQ L/ 7639
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.
FOM7 HL IO 1979
PreSCnCeO By State Bw�tl af 7a+ Cammissione�s
CLAIM FOR HOMESTEAD PROPERTY TAX CREUIT FOR YEAR 192�
To Be FileC in Ou0licate
SEE BACK FOR FILING INSTRUCTIONS��� DOGJ �3 �OD
,•We A��-�a ��' _���,
of re ence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned ,
❑ are buying under contract
❑ have a beneficial iryterest in the taxpayer
Property Description
�G-�3 /� /�o-QaD.���—da �
Township
Taxing District (6itq-Tewrr, Township): �/
Parcel Number or legal description shown on tax statement:
If buying on contract Owners name "� �'"'ae °""e`� ��f� 3`��35�53�
�� �
Contract recorded in Recorders Office - Record No. Page—
If any portion of the residential structure or the land, not 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
/�hereb�
_ O,l
siatement is true, correct and complete.
Sveet
Township
i� `
��
City. S;a:e ana Zio �e
' 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 -
Land not exceeding 1(one) acre immediately
surrounding residential imorQTy�r�ls� �
Other Land � 1 L
Total Land
Residential Improvements ,1i.���
�� i
Other Improvements
� 1979
� True Cash
� Value
(t) SG d
�q�3 (2)
rt,�l \ (3) .�� O
�S°
Dw�ng
��'u�2�'�`�,�Tarage
AUDITOR otal
Tr'-'�Improvements - Line (6) plus (7) equals (8)
I�by�tity the above is true. correcl. and complete.
Siqr�awre ot
�4� ,i�99b
(5) —
cs� / _3 ,�9 0
(�) _�
($) �
- ACTION BY AUDITOR -
Assessed
Valuation
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Homestead
Valuation
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Date: r
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