Homestead_KolbFOBM HC 10 1979 �
NeuriDeO By State BoarE of Tax Commissioners
CLAIM FOR HOMESTEAD PROPERTY TAX CHEDIT FOH.YEAR 1979
To & FileE in Duplicate
SEE BACK FOR FILING INSTRUCTIONS
�(We) �� � � � ��6L`�- certify that on the 1st day of
arch, 19_1L, I, (We) occupied as our principal place of residence the following described real property for
which a Homestead Property Tax Credit is hereby being claimed:
I, (We) ❑ owned DQ��O113y
I� are buying under contract
❑ have a beneficial intere t in the taxpayer
Property Description in �/-� County D�z-�- Township
Taxing District ������ Township): `7��^-
Parcel Number or legal description shown on tax statement:
`J i�-. �S'l�cJ �%< / S - z - i o . �! z_ � z �4 )
If buying Ofl contract: Owners name ��� s�mo�e owne.l
Contract recorded in Recorders Office - Record No. Page
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
Any other counties in which individual owns or is buying real property: County Township
�hereby certify the above statement is true, correct and cortiplete.
v " . � ,- /�0� � �i�.��� �r-�.-e � ��.4 �� �� �
'Signa�ure Street Aotlress Giry. Scate ano 2iv Code
' Individual either owns or is buying under a contract that provides he is to pay the property taxes
on the residence, or has a beneficial interest in the taxpayer.
- FOR ASSESSOR'S USE ONLY -
Land not exceeding 1(one) acre immediately
surrounding residenti�mp�verrCuents � �
Other Land [�.
Total Land
Residemial Improvements •�U�'� 2 0 1979
Dwelling
��Ll/�`k ^f '—Garage
, � '2 'd�Cpit�TOtal
Other Improvements �j AUDITOR
Tr' Improvements - Line (6) plus (7) equals (8)
I�h�� certify the above is true. correct. and complete.
SigndNre ol Asus50r
Approved
True Cash
Value
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(2) '
(3� �/ o
(a) S"a7c
(s) —
(g) S Z 7 c
(�)
(g) S z7 0
- ACTION BY AUDITOR -
Assessed
Valuation
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a
Homestead
Valuation
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6 - 7 -79
oa:e
Date: � 79
Gibson County Auditor
101 N Main
PRINCETON IN 47670
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i
ST{{[lO0.M!)MIR:laW1
rarnsuuxrozw��n
IndiriJual. and inarriN couplcti are limii<J to nnc hnmc.acaJ uandaN d,Nuninn. A. �he rttcipt ol �his deduttnn Rcome.
murc beneficial, therc i� morc incenti�t Oun e�cr fur home.rcml G.mJ. Ilume.rcad GauJ causcs highcr lac hills for all; the¢for<.
HEA 13+3-30R9 requires u�paren who reccire the hanestmJ siandard dNuciion to verifi� tivi they are elieiMe to mcei.e the
benefit an1 to pnw�ide aJ�litiunal idemiiying infumvniun �xcoan� io allw' county guvemmmt m beucr monimr fwmesrc.�d
lilin��.'Ihi. inlmmmion xill M lqx canlidenlial anA can nnly h. arersuA h�� aWMriinl rnunh� n17ti�,iG.'Ihe IXpannmm of
i
1_ucai Gm<rtvncm fivnm w ill ua this iniurtnation �u crcam hvls �Iw� a'ill hclp counn' ufficials climmarc lrc�mcACad fiaud.
. • ' , , , "
Taxna�•er Name Propertc Address
Kolb, Belty Lou ,
� 1601 5 ��'ashinetan AVH
Rinc�KOn I�I d7670
3908
Betty Lou Kolb '
1601 S Washington State Parcel NumAer Le�al Descrii�tion
PRINCETON IN 47670.2945 �
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g Addre�s (numbcr m�d � c[, tiry, sutc,
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ocial Sccuriry Numbcr (last 5 dic�u) Dr
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.4ddrcss (Number nnd str<e4 ci�y, s�aie, and ZIP coik)
urity Numbcr (las[ 5 digics) Drivcr's Liccnsc/Statc ID Niunbcr Qa t 5
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Sumc ns pmpem'uad�
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Each undersigned certifies, under penalty of perjuq�, that the above and Poregoing infortnation is we and cortect and that he or she is eli�ible to
receive the homestead standard deduction on this propeny. Each undersiened al>o understands that, by claiming additional homestead deductions
unlawfully, he or she may be liable for back tases and substantial financial penalties. �
i
Owner I Signanuc Uatc 7'Ncphonc
( )