Homestead_KelleR, CLAIM FOR HOMESTEAD PROPERTY TAX
' CREDIT/STANDARD DEDUCTION
State Form Sd73 (RB / 403)
Presrnbed by lhe Department of local Govemmen� Finance
INSTRUCTIONS: See Bverse side lor /iling instructions.
i Mi0) L.( ,(AiL(�.i ��� � C�(j,�7�,�IPC TJ1L%CJ�-�� M A1
I(We) occupied as our principal place of residence Ihe following descnbed real property for which a
❑ I(VJe) owned ❑ Me buying under contract
` Have a benefidal interest in the entity that is liable tor the property taxes on the propef{}/antl��
If huying om m�iraG, Fee Simple ovmefs name
Remrtlefs ofice where mntrect is
Counry
Tamstdp
ia�ing aislrict (tiry, town,
FORM
HC10
YEAR
���
i
on the 1sl day of March, 20_
erty Tac Credit is hereby daimed:
buying under a contraU.
Record number � Page
r�l��.L4�Vll IL�.S� IoC7C �(�IL.N�N�-/�1eCroPenYinqueslion:
� }Ql ❑ Real property ❑ Alobtle Homo (1 C b f 7-n
If any portion o/ Iha resitlentlal sW cWre or Ne land not exceedinp one (1) aae that immediately wnounds that swGUre is used b produce income, desuibe the use and portion
ol lhe proparty ulilize0 to produce inmme. �
County
Tavnship
I hereby certify the above statemenLs are We, corted and compiete.
and sf�et. city,
Coumy
TO.vnship
'� s i'���".�`�.ez.a` .�..�' .m `�`- �^ %° . '� -t ... - � NON�RESfDENTIAL `�'3i
��p ��r� � TRUETAX +��i ASSESSED�VALUE �HOMESTEADk
i� K`.�''.t�� �rE3'S`��'#F6��.zN...LY:d'�. y ' ��� ���.-VALUE��� '�AT.�00°/a�„OFPSTN� �rVALIJE�� ������i�U,E�ifi,t.�.�'��.
Land not exceeding 1(one) acre immediatety ;`;ti��c�`J�..� .,$�',�Y�.?
surrounding residenHal improvemenLS. (�) �E'``' r `�,.-�;;��;;.'
Other land (Z) �� �
Tdal land (line 7 plus line 2) (3� Y t. .✓'i
✓t n�" D
0" '/
Dwelling (4) , ,��.r � �y ��'„�������
Residential improvements w MnuaDy �71' /��d Q��
A��d �h�e / Man�red Hortre Garage (5) Y`1J 4�v�.`�'� ,�G`,
1 s���-_ �
Other improvemenis (5) :s�
:3
Tdal improvements (line 4 fhrough line 6) (�)
TUaI value (line 3 pl�s line n � (g)
I hereby certify ihe above is We, coned, and Signamre otnssessor oate signed
complele.
Veritying action - Sigriature oflwdimr Date signed
20_Pay20_
Lesserof 1/2 Homestead
vauauon a 535,00p
@
, `.�Cr,C _ n_ � O I Date si n ^ O q
w } si.�.�%�%� (�L `l
•
Gibson County Auditor
101 N Main
PRINCETON IN 47670
iass
�� VE fORY �)!M Iti / ��MI
� TSASI�RFAffMY.%IA
PALV1U0m0Y iil[ DE�MI�RYf <4 LhAI C+T'cL :.lI.TNnSfE IPH.1"11
InJividuat> anJ ina;riN mupks are IimiiN �o ore homewead uamlaN d�rluniun. A. �hc rcceip� oi Nis dnlunion bttonree
morc beneficial, thrrc i. morr fncrnmx Ihan e�rr far home>te:wl frauA. Ilome�reaJ ireuJ eauses hi�her tac bilis for ell: there:az.
HE.\ I: N-?009 requims �azpa.en who reccire Ihc han<s�eaJ smndird JNuction to .erity tivt tM1zy am �IieiMe io mcei.e the
brnefi� ani ro p�w'idr a�kliiiortN idemfirin� infurmanun �nYCSnn� ro allw' cauntt go.'rmmmi ro Nu�r monitor humeseaU
lili��. This iNnrmaiinn .rill be Aery cmli�'cntial and can nnl�� h• acan.cd bc nwMrireJ cnunq� of(ri�l:'Ihr Ikpannmm of
I.ocal Gmcmmrn� Pivnce �vill u.c this intormation ro arcam niulx ihat will hcln camrv ufficials climimrc humestead Imud.
David A Kelle
3312 W Mary Roberts Dr .
PRINCETON IN 47670-8473
�i�i����������i��u����i������n�ii��iu�n��iin��u�i�in���
Taxoaver Nnme
Kelle, David A/Martha R
�
State Parcel NumAer
26-11-15100-004.236-027
V
/ R3 Rox
1'rinceton I
006-04236-00 M C ROBERTS TICHENOR
RD PHASE II 3 I
�' 1
Ou�ntt I First Middle ! Lut
�.u�� A��� �e.(l� i
gAddress(numbcrund>irccLCity,statc.antlZlYcoucJ.�... . --...-'-'...--'�Sumcmprupenrixidna '- -� -'-
33 � Z t,J {L�ar (� b�r�s �i - J"'c�-n e�u� 2N N7e--�o
$ocol
Spou;c First h1iddle ' / � ��
j�l a�%Iti a `IZ o5 e t� ���-�-
Mailing Addrcss (Number and slree4 ��}'. stalc, und "LII' cu�k) � Same ai pmpem add2ai (
33iZ u1 /�lav ,���bec-i-s �L c. r��c��m s� `f7L-�6
SwialStturiry Numbcr (last 5 dieits) Drivcri Liccnu/Statc ID Numbcr (la t 5 digils) Other (plcasc spccify in Part 4 bclow) j
� � � '!� / � I
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Each undersigned cettifies, under prnalty of pepury, that the above and foregoing informatiun is we and cortect and that he or she is eligible to
receive the homestead siandard deduction on ihis propeny. Each undersiened al>o undemands that, by daiming additional homestead deductions
unlau�fully, he or she may be liable for back taxes and substantial financial penehies. {
Ow I Signa�uc Ihtc 7'cicphonc �
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