Homestead_Keith •
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.Vmm'En BT 5r OE WORN OF nrtiti.\Ta.9v EA(SEWBm BY ow OE>MMYC OF LOCAL Ca 0.NW:Pa rDASCE IC 11-1.1-224.1
Gibson County Auditor
101 N Main IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON iii 47670 Individuals and married couple are limited to orle homestead standard deduction.As the receipt of this deduction becomes
more beneficial,there is more incentive than ever for homestead fraud Itomeiread fraud causes higher tax bills for all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to verify that they are eliribe to rteene the
benefit and to provide additional identifying information nee sary to allow county government to better monitor homestead
filin�ix.This information will be kepi confidential and can only be accessed by authorized county officials.The Depantnou 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
Keith, James Robert/Virginia L
RI Box 41
Oakland City IN 47666
4257
James Robert/Virginia L Keith
195 N 1050E State Parcel Number Legal Description
Oakland City IN 47660-8622
III I I I I I I I I I I I I I I I I III 26-13-11-200-000.580-006 003-00580-00 PT SE NE 11-2-9 1.40 AC
rn ut1 to n utnn tut rnr tot t u t s C-1
PART 2:TAXPAYER INFORMATION
Owner I First Middle 'L I p Last
mES �1 Db�r f 1C� I x-h
tg Address(number and street,city,state,and ZIP code) - -- - _- Same as property address - - - _ -—
5 1� — DSO E.
• Spouse First Middle Last
Utt^�tni A �Qcoon
\ E.
Mailing A ress(Number and street,city,state,and ZIP code) El.Same as property address
5 1
14 - I DSD V�
Each undersigned certifies,under penalty of perjury.that the above and foregoing information is true 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 liable for back taxes and substantial financial penalties.
Owner I Signature Date
CLAIM FOR HOMESTEAD PROPERTY TAX r
s� CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5 -92)
INSTRUCTIONS: See reverse side for filing instructions.
YEARc
1 996
n
Xhrr
ALICIROR
CERTIFICATION STATEMENT --
'We) Y bl 11Q ar.. , J. - certify that on the 1st day of March, 19
r�) occupied as our princip I p ce of residence the following de ibed real property for which a Homestead Property Tax Credit is hereby claimed:
I,gl(We)owned ❑ Are buying under contract -
I._. Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the property or is buying under a contract.
CONTRACT RECORDED. - if buying on contract, Fee Simple owner's name
Recorder's office where contract is recorded Record number Page
'
PROPERTY DESCRIPTION
County _
Township
NON - RESIDENTIAL
Taxing district (ary town, township)
Parcel number
Legal description
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
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.
surrounding residential improvements.
(1)
ASSESSOR USE ONLY
TRUE TAX
ASSESSED
HOMESTEAD
NON - RESIDENTIAL
VALUE
VALUE
VALUE
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land r
(2)
Total land (line I plus line 2)
(3)
Dwelling
(4)
Residential improvements
Garage
(5)
,
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plus line 7)
(g)
certify the above is true, correct, and
Signature of Assessor
Date signed
Flh,mereby
plete.
ying action - Signature of Auditor
Date signed
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 112 Homestead
5
Valuation or $2,000
Signature of Auditor
Date signed