Homestead_Kisseli
r
a.°�-�°, CLAIM FOR HOMESTEAD PROPERTY TAX
;2��: CREDIT/STANDARD DEDUCTION
.�:�;� State Form 5<73 (R2 / 592) '
�aTi
INSTRUCTIONS: See reverse�side lor filing ins(ructions.
FORM
HC70
YEAR
) VU� enify.maton��tst�'day�of��Nn.9
) occupi as our principal p�ace of residenc t e following described real property tor which'a Homesiead Property Tax Credit is��iereb�
(We} owned ❑ Are buying under contract . . pp�n 4- �(1n5
4� .
lave a beneficial interest in the entity ihat is liable for ihe pmperty taxes on Ihe property and Ihai owns the property or is b�uying under a m� traci.
.
,(Y, i't,�„cs—s
RECORDED.
If buying om m�tracC Fee Simple owner's name
Recordefs office where contract is recorded
Recard number
' � PROPERTY DESCRIPTIO
Gounry � -• TownsNp . Tazifg distn ( , to• . tox hip)
b • - '
F�a?�Iil�m r ^ LXgal description
J�� U
If any portion of ihe residen,ial strucNre or Ne land not exceeding one (7) acre ihat immediatety surtounds that struciure is used ro produce income, describe ihe use aM ponion
of the pmperty utllized m produce income.
County
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
Township Counry
certiry the above statements are tme, correci and complete.
nurp�er a� sfree(,�, state, ZIP code) n
. � ASSESSOR USE ONLV
Land not exceeding 7(one) acre immediately
surrounding residential improvements.
Oiherland
Total land Qine 1 plus line �
Dwelling
Residential improvements
Garage
Other impmvements
Total improvements (line 4 through lina �
Total value (line 3 p�s line �
I hereby certify the above is irue, correct, and
complete.
0
of
19_Pay19_
Lesser of 1l2 Homestead
Valuation or $2,000
(�)
i2)
(3)
l4)
(5)
(6)
1�)
(8)
TRUETAX I ASSESSED
VALUE VAWE.
Assessor
STANDARD�DEDUCTION ALLOWANCE
S
HOMESTEAD NON-RESIDENTIAL
VALUE VALUE
Date signetl
Date signetl
/�
_ - ,•,
Gibson County Auditor
101 N Main
PRINCETON IN 47670
2358
John G/ Phyllis A Kissel
2097 W 100 S
Princeton IN 47670-9314
tINE F00.M!)M 1R'/ W+1
InJividuaLc aud inarriN couplrs are Iimi�M �o one home�ead sandard dedu.�iva A> Ne rtteipt oI thi�'Jedunion become�
more bcmficial, tMe i� morc incmtne dun aer (or M1omesrcael fiaW. Ilortwveal fiaW causes hit�r ta� bills (or all: thrrefore.
HEA 134-i-30Q9 rcquim iaapa�en who reccive thc hcunes�ead siandard deAunion m veriH �hai �hey ore eAciNc w recei.e ihe
benefit ani to p`w'id< a�klitio�ul idemfiyfnc fnformatmn necr.aan� �o allw' counrc gmemmmt to bener�moniror homrneal
filima. This in(omuiion x�ill M1e Aryw conLdential and can nnly M. acceunf by amhoriuvl counp� oRciais.�The Ikpanmem of
Lucal Guvemment fi�unce �vill u+e �his intormation to crcatt twls ihat aill h:lp cpmt7� officials diminate homestead fravd.
��i �� �
TaxoarerName Prnoertr AJdress
i
Kissel, John G/ Phyllis A i
�R i eo. a? r
� 1'rinceron IN I7670
�
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i
State Parcel NumAer Lesal Descrip�lion
I I I' I I I I I I I I I I' I I I f I I' I I I I 26-11'14-300-003.668-027 W6036 p00 PT NE SW 14 2 17 4.4353
� n n� � u �n n� i nn ini i n i n in n � i
� �
� hx,�- �h y iGrs
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Sf8[c, enA'LIY cude)—
S
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(Number and 9rce4 �iy, state, und ZIP nxie)
�oQ� w
31 Sccuriry Number (las� S digits)
�;ss��
S�mc�prcF.�'r:.dress -- .. _
..� i /�.. �
�sse
a s�� � n�ox� �a�
�ox� L/U �7�
hhcr (olcasc speciN in Pan 4 bclow�)
undersigned cerrifies, under penalty of perjury�, that the above and foregoing infoRnation is we and w�rzct and that he or
+e the homestead standard deduction on this propeny. Each undersiened al>o undentands that, by claiming additionai hoR
+fullv, he or she may be liable for back taees and substanrial financial penahies.
l��,c�a"�r� �-'�-/G
�
��� �
elieible to
deductions