Homestead_Martin 313.11 FORMSIM*it a r,Ot TREASURER FORM:31A
APFRO.'EO BY MIL BOARD Of ARTRi.\TS.Inn FREYNBFD BY 111E DE?ARMEIf OF LOCAL IXnca.VMIT't FINANCE K' I.I-SRI
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couple are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fraud.Homestead fraud causes higher tat bills for all:therefore.
fill HEA 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 he accessed by emNnrired county officials.The Depanntent of
Local Government Finance will use this information to create toms that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
_ Martin, Connie K
RI Box 56
Oakland City IN 47660
173
Connie K Martin
11297E Base Rd State Parcel Number Legal Description
OAKLAND CITY IN 47660-8469
I I III I I I I III III I I I I I I I I I 26-13-12-400-000.288-006 003-00288-00 PT SE 12-2-9 8.411 AC
to tit t tit n tit 1111 tit tit utnut to C-1
X
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
0, D4g ) E KAY /11ARTfAI
�g Address(number and streM,eiy,state,sod ZIP code) — -- O'Same as pmpcny uddr as ---
1/ a97 a RASE" PD , 014-k1,4' illh• C1 rY T Al 4-1I,l,. V - 11-1-49`I
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
sme
PART 3:CERTIFICATION
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 Signature Date
ilk
•
ti
'." CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (8215 -92)
INSTRUCTIONS: See reverse side for tiling instructions.
FORM
HC10
F1 Lt
YEAR
• CERTIFICATION
'11STATEMENT
' I (We) 1 ertify th t on a 1st day of March, 19_
I (We) occupied as our prin pa place of residence the following described real prope or which a H me d Pro Credit is hereby claimed:
❑ I (We) owned ❑ Are buying under contract f�OU14TY AUDITOR
❑ Have a beneficial interest in the entity that is liable for the property taxes on the p e�jlQAPWl owns the property or is buying under a contract.
CONTRACT RECORDED
If buying on contract, Fee Simple owner' s name
1
Recorders office where contract is recorded
Record number
Page
PROPERTY DESCRIPTION
County
Township
Taxing district (city, town, township)
Parcel nu r
-0D 'S'�-
Legal descriptio
{S SA- Ia -a-
, - yJ
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.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
County
Township County
Township
Sig ture oiclaimant
ereby certify the above statements are true, correct and complete.
Ad ess (number and street, city, state, ZIP code)
1 - 1
ASSESSOR USE ONLY
TRUETAX
VALUE
ASSESSED
V VALUE
HOMESTEAD
VALUE
NON -RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Otherland
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
complete.
Signature of Assesor
Date signed
Verifying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
.19— Pay 19 _
Lesser of 1/2 Homestead
Valuation or 52,000 .
-
S
Signature of Auditor
Date signed
1-3-01