Homestead_Marchal CLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD / SUPPLEMENTAL DEDUCTION FORM YEAR
r+ State Form 5473(R19/1-23) HC10 �Z4
Prescribed by the Department of Local Government Finance 1111
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone, Social Security, driver's license, state identification and federal identification numbers are confidential under IC 6-1.1-12-37.
CERTIFICATION STATEMENT
I(We) Sarah Marchal certify that I(we)occupied as my(our)principal place of
residence or am(are)buying the following described real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed on the
date this application is signed, 01/18/2024 (date of signature).I(We):
❑Own. ❑Am(are)buying under recorded contract.
❑Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation.
❑Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust.
❑Am(are)the shareholder,partner,or member be of the entity that owns the property.
Recorder's Office Where Contract is Recorded Record Number Page
PROPERTY DESCRIPTION
County Township Taxing District(city,town,township)
Gibson Center 004
Parcel Number Legal Description Is the property in question:
❑Real Property ❑Annually Assessed Mobile Home(IC 6-1.1-7)
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.
26-05-36-200-000.626-004
PROPERTY OWNED ELSEWHERE BY CLAIMANT
State,County,and Township Is Claimant Vacating a Homestead?
❑Yes No
Signature of Claimant
I hereby certify the above statements are true,correct,and complete. 0.vt,dan- 7AtZ
Address of Contact(number and street,city,state,and ZIP code) Address of Vacated Homestead,if any(number and street,city,state,and ZIP code)
4984 E 200 N, Princeton, IN 47670
ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE NON-RESIDENTIAL VALUE
Land Not Exceeding One(1)Acre Immediately (1)
Surrounding Residential Improvement
Other Land (2)
Total Land(line 1 plus line 2) (3)
Residential Improvements or Dwelling (4)
Annually Assessed Mobile/
Manufactured Home Garage (5)
Other Improvements (6) ry/Y�Q
c/e ?47y 41111141 ,
Total Improvements(Line 4 through Line 6) (7) SON
Total Value(Line 3 plus Line 7) (8) C‘c)4/Q"
Signature of Assessor
9 �Oj� Date Signed(date,month,year)
Si
I hereby certify the above is true,correct,and complete. OR
Verifying Action—Signature of Auditor Date Signed(date,month,year)
STANDARD DEDUCTION ALLOWANCE
20 _Pay 20 Lesser of 60%of the assessed value of the homestead or$48,000.