Homestead_Martin (24) AFAIE FORM!MAY ILrwn TUIW tell FOLV-,SIA
.VrRtw'EO BY SAVE BOARD AfrOMMR.9x r¢4Amt3)BY TIC DFPAAYMPAT OF LOCAL C{nrtMrrr FINANCE ICH.I-E]4.1
Gibson County Auditor
101.NAilairi 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 ner for homestead fraud.homestead fraud causes higher tat bills for all:therefore.
• HEA 1344--2009 requires taxpayers who remise the homestead standard deduction to verify that they are elieible to receive the
benefit and to provide additional identifying informaton race:ary to allow county government to better monitor homestead
filings this information will he cep confidential and can only be accessed by authorized county(Initials.The Depanment of
Local Government Finance will use this information to create toasts that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Martin, Scott A
305 li Strain
Fort Branch IN 47643
7839
Scott A Martin
305 E Straun St State Parcel Number Lesal Description
FORT BRANCH IN 47648-1418
Iriuilut�tllntlu IInInnlltlu1m111n 1t11nu1t1ul1r11 26-19-19-101-000.408-026 011-00408-00 SMITH ENLG 1
•
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
_ 0* _ AIavv filar n
isAddress(number and stem,city,state,and ZIP code) -- [a Same az prupenyaddress— — —' - — -- -
305 C . 3-cc c\ S* . , 10CA 3cav■64 , i-SC 11241K
Spouse First Middle Last
ed rmbe r 1 t a-1-1\e . l�aop yk
Mailing Address(Number and street, state,and ZIP code) r ,,s ,x t Warne as property address
3o5 £ - S-krb;.v� � • i co\ * '3caYLek , --- c\.Lcl. )41/9 47
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 r a. estead standard ded lion on this property. Each undersigned also understands that,by claiming additional homestead deductions
unlawful) y or she may be liab or back taxes and substantial financial penalties.
Owner I S/ature Date
III
� :.,,E o
i °
r, ��•
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CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT/STANDARD DEDUCTION
State Form 5473 (R2 / S92)
FORM
HC10
��
YEAR
�/ INSTRUCTIONS: See reverse side 7or /iling instructions. - � ���
�LJ
.' _ - CERTIF{6Ai1GN TATEMENT C
1(We) certity (fia on the i sYday of March, �9_
I(We) occupied as our principal place of residence the foilowing descnbed real property for which a Hwneste Property T Cr is h r imed:
❑ I(We) owned ❑ Are buying under contract �'�cnN COUNTY AUO�TOR
❑ Have a beneficial interest in the enfiry that is liable for the property taxes on the pmperty and thai owns t e �rnparry or is buying under a contract.
� CONTRACTRECORDED - � �
If buying on contraa, Fee Simple ownefs name �
Recortlels oHice where conVact is recortletl Fecord number � Page
PROPERTY DESCRIPTION
Counry - - Township � . Ta�dng distrid (ciry, town, township) �
- Parcel number 0_ Legal tlescriph�pn C—
�\�J
It any ponion ot the residential structure ar ihe la(W not e:ceedmg one (1) acre that immediatey surtounds t swcture is used to produce inmme, describe Ne use and portion of
ihe property util¢ed ro protluce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTRIES -
Counry TovmShip Counry Tawnship
SignaWre aimant
•iereby certify the above statements are true, correct and complete.
AOdress (numberandstreet, city, state. Z/PCOae) -
ASSESSOR USE ONLY TRUETAX ASSESSED HOMESTEAD NON-RESIDEN7IAL
VALUE VALUE VALUE VALUE
Land not exceeding t(one) acre immediatery (��
surrounding residential improvements.
Otherland (2)
Total land (line 7 plus line 2) (3)
Dwelling (4) -
Residential improvemenis
Garage (5)
Other improvements (6)
Total improvements (line 4 through line 6J (7)
Total value (line 3 plus line 7) (8)
I hereby certify Ihe above is true, conect, and Signawre of Assesor Daze signed -
complete.
Verifying action - Si9nature of Auditor � Date signetl
• STANDARD DEDUCTION ALLOWANCE
- 79_ Payt9_
Lesser of 1/2 Homestead �
Valuation or $2,000
Si �Nre Audiror � � Date signed
i /
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