Homestead_Martin (21) STATE f nRN')wiKC tort rlrASUtnR FORM:11A
.APP0.tw'En BY SIATT.BOSPtO€ArMI:NT3.Iwo PtrrraaED BY TIN DEPAnTSQ.`ITOE LMAL r ovuornrM rNAH'E M♦I.I-L'-li.I
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 homes
more beneficial.there is more incentive than riser for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
• HEA 1344-3009 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to recebe the
benefit and to provide additional identifvine information necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only he accessed by authorized county officials.The Department 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, Glen E/Carrie A
8061:Walnut
Fort Branch IN 47648
7786
Glen E/Carrie A Martin
806 E Walnut State Parcel Number Legal Description
Fort Branch IN 47648-1240
/ 0
it III I II I II I II nI or !/I I 26-19-18-304-000.148-026 11-00148-00 HOLCOMB ADD 90/88PT/89
to rot nr n u nu nt rII n III ur II nu
PART 2: TAXPAYER INFORMATION
Owner I First Middle r last
�g Address(number and street,city,state,and ZIP code) — '' e as property addrecs— - — - - -- ' —
Spou,fl First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) •
ne as property address .
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 Dale
,s s*,*E o YEAR
���„ CLAIM FOR HOMESTEAD PROPERTY TAX FoRM
, � CREDIT/STANDARD DEDUCTION � HCto
e
��.� i' State Fortn 5473 (R2 / S92)
�'i��� L\ .Y
\uyb/ ; �+q •
INSTRUCTIONS: See reverse side lor /iling insWCtions. .�� a��
p 1..�.%! • "
� �, _ .. .
� CERTIFICATION STATEMENT � �
�
I(We) � certi ihat on the 1 st of Ma . h, 1
I(We) occupied as our principal place of residence the following described real properry tor which a Homestea �roperty Tax re '�s her la ed: -
❑ I(We) owned ❑ Are buying under coniract � ' �J•��� y}Uu1T,0^
�/ ta�;ON ,
❑ Have a beneficial inierest in the entiry that is liable for the property taues on the property and that owns t11e property or is buying under a coniract.
CONTRACTRECORDED
If buying on contract, Fee Simple ownets name
Recorders omce where coniract is recorded � Recortl number Page
PROPEflTY DESCRIPTION �
Counry - Tovmship Ta�ting dis[rict (ciry, town, fownship)
Parcel number �` oO Legal descnption /?,��1✓ •'�� � V v L
l
If any portion of ine resitlential siructure or Ihe land not exceetling one (1j acre that immediatey sunounds that sWCture is usetl m p otluce income, describe the use and portion ot
Ne properry utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES
Counry Township Caunry Township
ignature of claimani
ereby certify the above statements are true, correct and complete.
ACdres number and streer, ciry, re, ZIP code)
ASSESSOR USE ONLY TRUE TAX ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VAIUE VALUE VALUE
Land not exceeding 1(oneJ acre immediately (�) '
surtounding residential improvemenis.
Oiherland (2)
Total land (line 7 plus line 2J (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)
I hereby certiiy the above is true, correCt, and Signature of Assewr � Date signetl
complete.
Veritying acuon - Signature of Audimr Date signed
�'��' STANDARD DEDUCTION ALLOWANCE
19_ Pay 19 _ .
Lesser of 1/2 Homestead S
Valuation or 52,000
Signature of AuCitor DaLtye gned
J � �O�
_ II