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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Fortn 5473 (R2 / S92)
INSTRUCTIONS: See reverse side lor filing instructions.
FORM YEAR
_ �HC10-
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CERTIFICATION STATEMENT
I(We) ertity th day of rc 9_
I(We) occupied as our principal place of residence the following de cr ed reai property for which a Hom _,_ wp� , i,i� laimed:
❑ I(We) owned ❑ Are buying under contract �
❑ Have a beneficial interest in the entity that is liable for the property taxes on ihe propeAy and that owns ihe properry or is.buying under a coniract.
CONTRACT RECORDED �
If bu�v�g on conVact, Fee Simple ownefs name
Fecordefs office where conVaci is recorded - Recortl number Page
PROPERTY DESCRIPTION
Counry Tmvnship Ta�ting district (ciry, fown, township)
Parcel number Legal descrip6on
�- a- � � 3-a-�� _� I ��
If any portion of the residentiai sirucWre or the land rrot exceetling one (1) acre that immediatey surrountls that structure is used to produce i�ane, tlescrihe ihe use arW poNon ol
Ne property utiized ro protluce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township Counry Township �
ion o laimant
�ereby certify the above statements are true, correct and complete.
Adtlress (number and streef, ciry, stafe, ZIP oode) �
��c3 �zY�.`� Mcs.�'o.i L+� `E� 67
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDENTIAL
. VALUE VALUE VALUE VALUE
Land not exceeding 7(oneJ acre immediately (�)
surrounding residential improvements.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4) -
Residential improvements
Garage (5)
Other improvements (6)
Total improvements (line 4 through line 6) (7)
Total value (line 3 plus line 7) (8)
1 hereby certi(y Ihe above is true, Corrett, and Signawre of Assesor Date signed
complete.
yVerifying action - Sgnature of Auditor Date signetl
� STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _
Lesser of 1/2 Homestead c�
Valuation or 52,000
Signature ot Auditor Date 5 n ^ ,�y�
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Gibson County Auditor
101 N Main
PRINCETON IN 47670
MFILEI�
APR 3 0 Z010
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— pIBSON C �NTY AUDITOR
Mark A/ Kimberly K Marvel
2651 W 100 N
Princeton IN 47670-85�
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Individual. anJ ma:riN muplo are limited to one homc�tcad ,.tandaN dedunion. As �he re[ttipt of ihu Jecluctan beconrem
murc beneficial, thrre is more incen[ne dun ecer (ur humn�eacl fnud Iiomutead frami causa higher �a� bills tur all: therefore.
HE.\ 13M-?fMW rcquims uipa.en x�ho receire ihe hanesimd smndard drJunion m verity ihat thcy arc eligiNC w recci.c thc
beneni aml io pruviJe mkliiionai idemifyinp fnWmuition nece.san tu allw� county grn�rmment ro bev<r munitor humese:x�
�ilinE.'.'lliic inlormLion w'ill M Ary4 ennliJemial anA r.m nnle h arcrsud by amlwrizeJ rnunh� n0iti�ntc "fhr Depanmem o(
Lucal Gwemmem Pinance ��ill u e rhis iniorma�iun ro crcau twls �hm �ri0 hdn counrv atTxial. <liminmc hume.mad fraud.
Taxpa��er Name
Marvel, Mark A/ Kimberiy K
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State Parcel NumAer
26-11-03400-003.572-02 7
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006-03572-00 PT NE SE 3 2 11 1.87 AC
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indersi�med certifies, under penalty of pzpury•, that the above and foregoing in(onnution is trve and corrzct and that he or sfie is eligible to
: the homes�ead standard deduction on lhis propeny. Each undersigned al;o understands that, by claimin¢ additional homestead deductions
Cully, he or she may be liable for back taxes :uid substantial financial penalties. �
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