Homestead_Martin (18) 1L11E IORM!)!w1R:f 5-0.1 MEASURE,fORM SIA
.1rreocrn BY Stilt YHPDIK.Mri1:NLt.7.0 etr9LRn1m BY no DEPARr OF LOCAL(W)VEL'IUcI FLNAYCEtc VI.I-r4.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than cler for homestead fraud.Homestead fraud causes higher in bills for all;therefore.
HEA 1344-7009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to ovens the
benefit and to provide additional identifying information necessary to allow county gmemntem to better monitor homestead
filing.'Ibis information will he kept confidential and can only be accessed by authorized county officials.The Deponent 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
Martin, Gerald/Margie A goy 6-, LJ!_6 r1/
J07 C Clen
- —- - • - _ _ Fort l3ranch IN 47648
7655 _ - - _ _ _ —_ . _
Gerald/Margie A Martin
309 E Ulen State Parcel Number Leal Description
Fort Branch IN 47648-9703
�t�tt��ttt�t��ttt�tt��tt�t�t�tt�ttt��� lltiittt ltittrtiltl 26-19-18-301-000.497-026 /011-00497-00 HILLCREST 65PT
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
GC"2At 7J flAJC7 n/
allow.Address(number and street.city,state,and ZIP code) -
307 E. 1.1L641 sr fr /.�/ZA4'CH IA/ 1176414S
Spouse First Middle Last
DCe CC 4 S S D
Mailing Address(Number and streeL city,state,and ZIP code) Same us property address
Social Security Number(last 5 digits) Drivels License/Suite ID Number (last 5 digits) Other(please specify in Part 4 below)
snit
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
PART 4:ADDITIONAL INFORMATION
wxn+ nc �o ism + Ta ee Fna �� woi�ca�e
HeuriGeG By State BwN af Tax Commiuianers
CLAIM FOR HOMESTEAU PROPERTY TAX CAEDIT FOR YEAR 19 � 9
SEE BACK FOR FILING INSTRUCTIONS Ol�_�l�7 D�
'_�. `Yv�-�.�r ��. �- �'h��-x�-
�(We) Q' certify that on the 1st day of
arch, 19 "1`) I, (We) occupied as our principal place of sidence 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 interest in the taxpayer
Property Description in ��-M County � Township
Taxing District I[`i�tv _T. ow�, �ewnSfiip): ��'- �$/�-a-^--L�-
Parcel Number or legal description shown on tax statement:
j�l-�e�� � s 4' �.
If buying on contract: Owners name �'� �""we Oxne'�
Contract recorded in Recorders Office - Record
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 Township
' hereby certify the above statement is true, correct and complete.
� � �/�- � �e.�.,� .b�
a�a
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 improvements
Other Lan
Total Land� � � �
Residential Improvements
`i���� �
}9j9. Dwelling
Garage
� Total
Other Imprdafeine/r/�s•' AUDITOR
T�' ' Improvemef�is - Line (6) plus (7) equals (8) "
I�oy certify the above is true. correct. and complete.
,- � � . _
SignaNre of Rssessor
Approved
True Cash
Value
(t) /a2Cco
(2)
(g) /�-!oo
(4) —�—�2-900
c5) / 85�3 0
(6) �
(�) �
�g� o0
- ACTION BY AUDITOR -
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Date: �l��'9