Homestead_BartellN R•n� CLAIM FOR HOMESTEAD PROPERTY TAX
'y � � CREDIT/STANDARD DEDUCTION
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'' State Fortn 5473 (R2 / 5-92)
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INSTRUCTIONS: See �everse side !or liling instiuctions.
FORM YEAR
HC10
� . . . . ...;� . . , . _ . . : . ` ERTIflCAT10N MENT•: s ... ,.. .... ..._ _.. , . .�. a . . _. _ � . ., .
. . . . :.� . . .. _ . . . . . �.,.�. ...._• ^ •� .0 � ". '� ' .
I(We) __ certity that on the 7st day of March. 19_
I(We) pied s our principal ptace of r sidence the follovrin described real property tor which a Homestead Property Tau Cr t,is here6y daimed> ��,_,
I(We) owned ❑ Are buying under contract ����� �
� Have a beneficia� interest in the entiry that is liable for the property taxes on the property and thai owns the property or is buying under a contract.
_ . . .. . � /..:� . _ .- -�
If buying on contran, Fee Simple owner's name -^-!
-�iJ
GIBSO�a::tn�nrv n�mn��
tiecortler's office where contract is recorded Recortl numDer Page
. ' . � ' . � � PHOPERTY DESCRIPTI � - � - � b. �,: �"� � - ' .
Counry Township T�ing dis i(crty . OwnShip
rce�n r ^ I���� ,� Legal desttiption
...�1 \ J
It any poN � of ihe residential stmcture or ihe land not ezceeding one (1) aue Nat immetliatety surtounds ihat stmcture is used to pfoduce income, tlescribe the use an0 portion
of Vle O�oOerN utilized to produce income.
� PROPERTY OWNED BY CWMANT IN OTHER COUNTIES
Counry Township Counry
I hereby certity ihe above statemems are true, correct and complete. � Signawre o� �mam
,iress (numberarHstreet. uy, slate, ZlPCOde)
; K R 3 R� x S/ L S�r �•,.<c�-o
. ASSESSOR USE ONLY .,
Land not exceeding 7(one) acre immediately
surrounding residential improvements.
Other land
Total land Qine 1 plus line 2�
Dwellin9
Residential improvemenis
Garage
Other improvements
Total improvements (line 4 through line �
Total value (line 3 p�s line �
I hereby certify the above is true, correct. and
complete.
Veritying action - SgnaWre of Auditor
19_Pay19_
Lesser of 1/2 Homesiead
Valuation or 52,000
TRUE TAX
VALUE
(�)
(2)
(3)
l4)
(5)
(6)
P)
(8)
SiqnaNre of Assessor
5
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i 4 %67G
ASSESSED HOMESTEAD
VAIUE VALUE �
Township
NON-RESiDEN77AL
� VALUE
Date signed
oare signea
DatE'S�ed ^ �
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O
Gibson County Auditor
101 N Main
PRINCETON IN 47670
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782
sun raca ��s..�ti i e+ni
nr..suuxroxv:su
Indiciduals anJ inarriN couples arc limimd �o onc hmmc�caJ uandaN dcdunion. As �hc rmtip� ot �his dedunion becomes
mure beneficial, thrrc is morc incrncna th�n rc<r for homesrcaJ fraud. Ilomn'rcad frnud causes hi�her ta� bills fur all: thrr<forc.
HEA IiS3-?(109 r<quim u�paren who receire ihe hanare�J nanda�d dc�iunion �o .eri'ty ilut �he.� arc eligide to mcenx �hc
benefit ani ro pnr�idr ahliUO�ul idemiirin2 inLxmatiun rieirnry �o aliw' oounn� em'emment eo Nnrr muniror MmesrcaJ
film��. This in(nmutinn vill 6e l.e7v cnnlidrn�ial and can nnl�� h: accr�.nl Ap autinrvcrl cnuniy ofTiciaL _ lM Iklunnum nf
Local Govcrnmem Fina�e �� ill u.< �his infonnation W aea:e mols ihat x�ill h:lp camtt• officials dfminah Iwmc>mad kaud.
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Tnzpacer Neme Pn�pert�� Address
Bartell, Mark / Lisa
Mark / Lisa Bartell
1766 Dunlap Drive
Princeton IN 47670.8629
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State Parcel Number
2G05-2830 -001.774-027
1766 Uunlap Drive
1'rinccton IN 47670
LeQal Description
006-01774-00 PT SW 28 1 10 6.00 AC
C-1
Oaner I First Mivale
� G�-� `� �Gr�e \\
�g nAdnss (numlxT end svex<,-ciry. s`a�c. and ZIP cuJc) -- - ��m: a; FT�'ui nY ��� —'---
17�� D�,..�., or:�� P�;,.«-�w. � ��6�0
$ocial Saurily Number (last i dieiu) driveis Licrnx!$ta�t ID umber (lazt 5 digiB) Othcr (pinse sp¢ifv in Pan 4 below)
Li Sh �Arp � ...._ 2 P�r� `\
U
g Address (Number and strce4 cii)', siale. and'LIP cak) �S��e u pmpeny addrtai
Stturirv Numbcr �laz� 5 digia) Drivcts Liccnsc/SWCe ID Nwnbcr (lau 5 digits) O�her (ylcssc specify in Pan 4 bclow)
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undersitmed certifies, under penalty of perjury�, that the above and foregoing infortnation is we and correct and that he or she is elieible to
�e the homes�ead standard deduction on �his property. Each undersiened al;o undersiands that, by claiming additional homestead deductions
,-fully, he or she may be liable (or back taxes dnd substannal financial penalties.
I Si�mauvc
6f�P2 /o
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