Homestead_Kissel (2)R. YEAR
} CLAIM FOR HOMESTEAD PROPERTY TAX FoRM
CREDIT/STANDARD DEDUCTION HC10
Slate Form Sd73 (R6140.7)
Prescribed by �he Deparimenl of Local GovemmeN Finance
See revcrse sidc lor lilinq insbucfions
� M�e) �— /� I terti that '� 1st da ch, 20
� °el9ie � �Y�GO� —
I(We) occupied as our prin ' aI place o( residence Ihe following d ed real property (or which a Homestead Property Tac Gedit is hereby daimed:
❑ I(We) owned ❑ Ne buying under wntract �S/ Q/�j
� Have a benefidal interest in fhe entlty Nat is liable for the property taxes on Ihe property and that owns the pioperfy or is buyiog!unQer� �" �U.
' GIdSUN COUnT r AUDITOR 1
If byvig om m�Uad, Fee Simple owners name
Recofders ofice where conirad is recordetl
Tamship
Rewrd number I Page
Pa�el�myer IO�� �' '� Legal deunption I Is the pro{Yerty in quesfion:
Ll L
l/ CJ ❑ Real DropeM ❑ Mobile Hwno (I.C. 61.1-7)
H eny ponion of the residenilal sWqure or the land not exceeding one (7 � aae Nat immetliatey wrrounds Ihat sUUCture is used lo produce inmme. describe Ne uu and poNOn
of the prooerN Wlized to produce income.
County
Tavnship
I hereby certi(y the above sWtements are W e, wned and complele.
(number and sUeef, dty, sfafe, ZIP code)
�
County
�--„'�'yPa��.^'f�....��lf�''��+.�'trs3'�rl'E4Pr'�R '14 C .. . "� }- �� +a+ ' �:�.
YASSESSOR�l1SE ONLY' o TRUE TA�X���}�* ASSESSED VALUE HOMESTEAD�i, . NONa2ESI0ENTIALa ?
��;�.,� .,�T�,.'°fl.,£'�b�t�'��..,-�_..`.�.i � i�� � VALl1E�'-`:;g�S�.. '8AT�100%�:OF TTV� �VALUE� �����-%,S°'.`yVALUE ���
Land nol exceeding 1(one) aae immediately ��"'� "'=��" "' �: �'r ��
surrounding residen6al Improvements. �� � � ���'��.'�� �' * "�.�
. < � �.�, a.�
Other land - ���� `�T �� .
(2) �'��� ���
Total land (line 1 plus line 2) (3�
� i� z:�-n -t nr t�:-.�.�-�c-,.-�
Dwelling (4) :�"� `'= - �'��yF R-
ResidentiallmprovemenLSOrMnuaOy "�"�^'"����"p ����"`'���'��'�
'�srT r°-
Assessed Mohile / Manufacturad Homa Gara e �� fa• t, , u�.'��,�����` "'s
9 5 �:� -� s � .
a� ,�.� �
,,,�;. .,Tr.�ti ��a `
3�,�-
Other improvements (6) �-s�"���.�;�'�
:3>....��T'+'3aN w�
Total imprrnements (line 4 through line 6) �7)
Rtal value (line 3 phs line � (g) �
1 hereby certi(y �he above is We, corted, and signamre otwssessor Data sgned
complete.
Verifyirg actbn - SgriaWre oflwditar Date signe0
20_Pay20_
Lesser of 1/2 Homestead
a
5
-1� -03
� �
�
Gibson County Auditor
101 N Main
PRINCETON IN 47670
u
lliiEl[1Ri�1!lM1Y`/�+MI
IAfANRIA H)RM �IA
IndividuaL� and martinf <ouple� are Iimi�N io cmc home.uesJ wndaN d.�-�iu.�ion. As ihe reccip� oi ihi; dcduciinn bettvnes
murc beneficial, thrre i� morc incrncne tlun aer ior homrstead frauJ. Ilomen�eael fiaW causes hieM tac bills tbr all: theretae.
HtiA 13�F1-?IX19 requim uapa.ers who rceive the hanesieaJ stanAard JeJuction tn .erify tfut the� are elieiNc lo mcenr ihe _
beneni anJ tu pnn'idr :¢klitio�ul idrntiiyin_ infumurtiun Mcovn� to allw� nwnn� gurmmrnt ro betmi muniror hunxrte:xl �
�ilin��.'Ihis inlarmaiion will M Ary4 cwfdemial and can nnly M� arre:¢d hy aWhoriieA tmnuy Mlicial�.'fhr Ikpanmem of
Local Gm<mment ('iwM'e will u c this fniormation ro crca[e Wuls tha� �rill h:Ip cwnn' offidalx dimimne In�mesmad iraud.
.', ,, '"
Tasoa��er Yame Pruoert�� Address
Kissel, Mark R/ Amy J i
� RI 60<�90
i
Prinreton IN;7670
2111 ' ,
Mark R/ Amy J Kissel �
4025 S 125 W . State Parcel NumAer � Leeal Description
Princeton IN 47670-9339 -
I I I I I II I I I' I I I' I I I I � I I I � I I 2Cr11-36-300-003.781-027 OU6-03787-00 PT NV�! SW 362-11 2.2176
� u u� i u n� in i nu u� � i ini i i i n i i AC D-17
V . I
(�umb..-rw�d��tu:: city� stntc: and Z!➢:odc)
iccunt� Yumbe� (last 5 d
city, stnte. and "LIP cak)
Security Numbcr (las[ 5
n rouama
v: 4�
��
K i55`E
�!�nmc ¢� pmpem mld�cc.
specify in Part 4 below)
I��.Al
� ame �u pmpem addrea�-.
Othcr (plcacc spccify in Part 4 Mlow�
,
�
'
undersi�ned certifies, und:r penalty of pepury, that the above and foregoing infonnation is true and coirect and that he or she is eligible to
+e the homestead standard deduction on this property. Each undersiened al>o undersiands that, by claimine additional homeitead deductions
rfully, he or she may be liable !or back taxes and substanrial financial penalties. i
i�-a9-iol �
ID
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