Homestead_Martin (12) . • STATE FORM•AM irI•■•l TRF.ASOIEQ WIN StA
APPROVED BY slATI-0FMRnoFMVYVNII.2104 PRFd[RIBFD BY THE DEP.ARTNIMT Of LOCAt GOVERNMMT FINANCE IC 6-1.1-2Z-I.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 e'er for homestead fraud.Ilomestead fraud causes higher tax bills for all;therefore.
® HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they arc eligible to remise the
benefit and to provide additional identifying infomlanon Ina:sans to allow county government to better monitor homestead
filings.This infnmution will he kept lonlidential and can only he accessed by authnrieed county officials.The Depanntent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART 1: PROPERTY LNFORMATION
Taxpayer Name Property Address
Martin, Kathryn L
5901 W 1200 S
Cynthiana IN 47612
9636
Kathryn L Martin
5901 W 1200 S State Parcel Number Lezal Description
Cynthiana IN 47612-8820
IllttlltttlEll IlrtltllttlllrFlrrrlElllrttil Ilrrrlll 26-22-18-200-000.683-024 00044-00683-00 W NW NE 184 11 20 AC
X
PART 2:TAXPAYER INFORMATION
Owner First Middle Last
aI-Atm L 111-yr 4
- -- - - - -
ag Address(nuncber and Street,city,state,and ZIP code) j tine as propem address' — _ — - — "
3-c161 w 1260s icy, t iana , to `/1GI a - se-0)76
Spouse 1 ' First Middle `
Last
V
Mailing Address(Number and street,city,slate.and ZIP code) • e 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 Sign tore ``JJ Date
•
FOFM HC 10 IW9
Presui0e0 By State Boz�a ot ia. Commissione�s
CLAIM FOR HOMESTEAD PROPERTY TAX CREOIT FOR YEAR 19 7 9
io Be FileC in Ou0licate
SEE BACK FOR FILING INSTRUCTIONS
, �,i- /^,/ n ,_.po ��t`- �dG�3 -oo
�(We�L�z��-L-�-z ` r��- r� ����� cz� • — certify that on the 1st day of
arch, 19 7___;_,9 I,�(We) occupi� principal plac of residence the following described real property tor
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ' owned �L-�a /�•�IjD�QGF�.(o83— L��
❑ are buying under contract
❑ have a beneficial interest in the taxpayer
Property Description in �-��-+-� County Township
Taxing District (.City- Fevrn- Township):
_____. Parcel Number or legal description shown on tax statement:
r'.c/� �/u�y ///Ey /8•y-/� �oa�xe
If buying on contract: Owners name
Contract recorded in Recorders Office - Record No
If any portion of the residential structure or the land, not exceeding one (t) 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:
� hereby certify the above statement is true, correct and complete.
County Township
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 improv�ent� � � �
Other Land
Total Land
Residential Improvements
Other Improvements
,� UI� 1 � �s7�,elling
� Garfi
Y �
AUDITOR
Improvements - Line' (6) plus (7) equals (8)
by certify the above is true. correct. and complete.
OI ASSPS50l
Approved:
True Cash
Value
(�) Soo
(2) y �/ 5/ o
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(4)�A3do
(5)
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- ACTION BY AUDITOR -
Assessed
Valuation
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