Homestead_Keeker (2) SESiE FORM IMIR_rl�Ml TRFAN 7•31A RER FORM IA
• •pPttw'En BY S1STr BARD Or NY04•STS.3lM nISCIIB1D BY 11W DEeaneT(4 LOCAL C RsMrsT F.aSCE l(-.tt-r-RI
Gilson 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 nor for homestead fraud Homestead fraud causes higher tax bills fur all:therefore.
• HEA 1344-2009 requires taxpayers who receive the homestead standard deduction to serifs/that they are eligible to reecho the
benefit and to provide additional idenmfvmg information necessary to allow county government to better monitor homestead
filings.This information will he kept confidential and can only he accessed by amhnriied comity officials.The Depannient 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
_ Keeker, Rickie L/Sharon E
RI Box 345M
Francisco IN 47649
4833
Rickie L/Sharon E Keeker
3705 S 650 E State Parcel Number Legal Description
Francisco IN 47649-9170
nt���nt���n r��un�r�r�r r�rl 26-13-31-200-000.337-004 002-00337-00 NE NE 31-2-920 AC •
n
D-10
PART 2: TAXPAYER INFORMATION
Owner I First Middle Last
e L _ K__eei(er
g Address(number and street,city.state,and ZIP code) --- Same as property oddress ---
37 o.5" S /So E ,ra"tces co ZNd / Q,t/2 , Se7Z `f 9
Spouse First Middle Last
5/ 2M) E t ,4� e e ie
Mailing Address(Number and street,ciy,stale,and ZIP code) El Same as property add,
3765 S 4,So & `r-aN✓ris o'/a. '/765'9
PART 3:CERTIFICATION
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�Signatre Date
0
4xE Rr
as a CLAIM FOR HOMESTEAD PROPERTY TAX
CREDIT /STANDARD DEDUCTION
State Form 5473 (R215 -92)
INSTRUCTIONS: See reverse side for filing instructions.
YEAR
0
APR 1 g 1998
' - - - .. CERTIFICATION STATEMENT"
q— ,�Q
I (We) t-sas 60 t- �9 9—
�e) occupied as our principal place of residence the following described Teal property far which Homestea Property Tax Credit is hereby claimed:
lj I (We) owned ❑ Are buying under contract - -
❑ 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 _
Taxing district /��ry, town, township)
Parcel number
Legal description
—40
//''
— V QL
If any portion of the residential structure or the land no 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.
�l
- - PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County
Township
County
NON- RESIDENTIAL
VALUE
Township
�eby certify the above statements are true, correct and complete.
Signature of claimant
ate ig d
Address ( numder and street, city. state, ZIP
3 S
�l
(�
ASSESSOR USE ONLY - _
TRUE TAX
.VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON- RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Signature of Auditor
ate ig d
Other land
.(2)
Total land (line I plus line 2))
(3)
Residential improvements
Dwelling
(4)
Garage
(5)
.
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 pfis line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
Verifying action - Signature of Auditor
Is
Date signed
I
STANDARD DEDUCTION ALLOWANCE
19_Pay 19_
Lesser of 112 Homestead
Valuation or $2,000
$ yur
Signature of Auditor
ate ig d
ffi. 0.V
/