Homestead_Marshall- A
CLAIM-F *0 h HOMESTEAD PROPERTY TAX FORM
CREDIT/STANDARD DEDUCTION Hcto
State Form 5473 (R6 14.03)
Prescribed by the Departnent of Local Government Finance
INSTRUCTIONS: See reverse side for riling instructions.
1l r
ICATION STATEMENT-:
I (we) certi-WoRthO lkst34
ty a 9 Y March, 20—
I (We) occupied as our principal place of re d nce the following des I cribed real property for which a Homestead Property Tax Credit is hereby claimed:
❑ 1 (We) owmed El Are buying un Pr contract Wa7� A �/
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the prop N rye iU tbqy.'
g.U&PCOtontract.
G,s S O
ONTRACTIRECORDED--- .
If buying an contract. Fee Simple owners name
Recorders office where contract is recorded Record number Page
�PFfOlI.EfITYOWNIE67BY CaIWANT
County
Township
Taxing district (0
r cur of claimant
�
Parcel number
—000/ W (T�
Legal description
Is the pro pery
i . n (pestion:
aI If
�deal
Property ❑ Mobile Home (I.C. 6.1.1-7)
It any portion of the residential structure or the land not exceeding one (1) acre that immediately it sActure
is used to produce income, describe the use and portion
of the property utilized to produce income.
Ala O` -,2(f - -3 00 - ooDw(f -0 .10
�PFfOlI.EfITYOWNIE67BY CaIWANT
County Township
County Township
I hereby certify the above statements are true, correct and complete.
r cur of claimant
�
(number and street, city, gate, ZIP code) Cl-
, 3 v 1/ 4: - /L)(? qJ7111424
20 _ Pay 20 _
Lesser of 112 Homestead
valuabon or $35.000
� .TRUETAX'
ASSE'SSED.V&UE
W HO
WffiTEAD"!
kAT100-AqFL7V
:'4
giz-
VAIUENAL
Land not exceeding I (one) acre immediately
surrounding residential improvements.
Otherland
(2)
E f=1
t
Total land (fine I plus fine 2)
(3)
Dwelling
(4)
lResidential improvements or Annually
Inv -
Assessed Mobile I Manufactured Home
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (fine 3 plus line 7)
(8)
1 hereby certify the above is true, correct, and
Signature of Assessor
Date signed
complete.
Verifying action - Signature of Auditor
Date signed
20 _ Pay 20 _
Lesser of 112 Homestead
valuabon or $35.000
SIAM rnRM T3M•IR:/f./) nY WltrR PORN ta.tA
APPROVED BYSTATE WARD Of M'XUMS!vW PUV(RIDED BY fur DEPARTyO•_4TOF LOCAL GOVELYMra FN.ASCE d'tl.l�u.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 sundani deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than tier for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
HEA 1344-3009 requires taspa■ers who receive the homestead standard deduction to verify that they are eligible to reecne the
benefit and to provide additional identifying information nor ary to allow county goverment to better monitor homestead
tilinfs This information will be kept confidential and can only he accessed by authorized county officials.The Ikpanndnt of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Marshall, Gary Michael
304E Vine SF
Patoka IN 47666
454
Gary M Marshall
304E Vine St State Parcel Number Legal Description
PATOKA IN 47666-9236
�r�tr��ttr�t��tr r��rrt��tt�t�rrrr�r�rr��rr��r r��rr rr�rr��rtr�� 26-04-24-300-000.018-020 018-00010-00 WOODS ENLG 20
9
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
�ge-y . M is fie _ Mats Az4 --
rIgAddress(number and st*t.city;state;tuid ZiP'eode)' '�'Sume us property uddreBS-
30 k -SS-o/sy
(.�
Spouse First Middle Last
Mailing Address(Number and street,city,state,and'LIP code) Same as property address
3°'54- .4574- v/tip ion 4/4 f'
Social Security Number(last 5 digits) Drivels Lice se/State ID Number (last 5 digits) Other(please specify in Pan 4 below)
I<% -Aft=• Snrc
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
Spouse , tore ' ` Date Telephone
( )
PART 4:ADDITIONAL INFORMATION