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Homestead_Kissel (10) cyarE r ORst" qR_/•. t RlASUiER CORN Sin AI IMWEt BY LTVEMaRO Of ACCONL.5w PLEALpnl BY Tilt DEPARTMENT Or LOCAL CAarrNMrsT EPANCE MH.I-r-kl 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 ncr for homestead fraud.Homestead fraud causes higher tax bills for all:therefore. 11.—' HE.A 1344-2009 requires taxpayers who receive the homestead standard deduction to verity that they an eligible to teethe the benefit and to provide additional idenofyine information necessary to allow county government to better monitor homestead tiling..This information will he kept confidential and ran only be accessed by authorized county oficials.The Deanntent of Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION Taxpayer Name Property Address Kissel, Harold RI Box 107 llaubstadt IN 47639 9473 - - - - - - --- - - - —— --- — - Harold Kissel 11721 S 425 W State Parcel Number Lezal Description Haubstadt IN 47639-8653 Itittlirttltlltt��t�l�tr�tt�tt��t till�tt t��tt llt�ltrll ill 111 26-22-09-300-000.540-024 004-00540-00 SW SW 9411 1 AC rt x PART 2:TAXPAYER INFORMATION Owner I First Middle J / Last Haro /d .: /65ie l ag Address(number and street,city,state,and ZIP code) III ' -- -i� --- Same as propem oddoss-- -_ .._. -_ - - _ __ 1172 r S. - 11.s w g it dsc1 f Ill - 1217 3 9 Spouse First Middle Last Mailing Address(Number and street,city,state,and ZIP code) ❑ Same as propeny address Social Security Number(last 5 digits) Driver's License/State II)Number (last S digits) Other(please specify in Pan 4 below) 5etc PART 3:CERTIFICATION Each undersigned certifies,under penalty of perjury.that the above and foregoing information is tore 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 be liable for back taxes and substantial financial penalties. � II FOPM HC 10 1979 PreSai�ed By Slaie BWrd al Tax Commissioners CLAIM FOR HOMESTEAD PROPERTY TAX CREOIT FOR YEAR 19 ?�> io Be FileE in Uuplicate SEE BACK FOR FILING INSTRUCTIONS yf D At�/� � / // �� e� QC/ �. U�/ j-t/ -O O �-�(We)�-�-��-.��-� certify that on the 1st day of March, 19�, 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) dd'owned G�ilo-o�o�-�/- �Q�-�100.�-Qc�� ❑ are buying under contract ❑ have a beneficial interest in the taxpayer Property Description in ��- County �- �- Township Taxing District (6ky, �eavR; Township): ��+-.-_�-�-�-Li � Parcel Number If buying on contract: Owners name!'� or legal description shown on tax statement: v i�l S/ � Gu y lC- 5�'// /2cst- 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 oi 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 complete. ' ��'�� / /��6 � ��`,� � % 'Signature Svee� naaress Cny. 3{are ana Zip CoGe ' 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 residenlial improvements T�otal Land � � � � � Residential Improvements i � �979 Dwelling JU_ Ga ar ge � ��/ti��,� Total Other Improvements �� AUDITOR T�mprovements - Line (6) plus (7) equals (8) I ��y certify the above is true. correct. and complete. oi nsseswr True Cash Value (�) �� o (2) — (3) .S�o 0 (4) %'/ % !00 (5) (6) _/ 4� 712Q 2 (�) — �s� / '� 7 Lc o Assessed Valuation �Z� . �� ' -- ��' '] O .S �?o? ' 7 Da:e Homestead Valuation jjj/jjj��j ��jjjjjjjj/ �� _- - �ACTION BY AUDITOR - � Date: ----�� f� � / f--�— /