Homestead_BalbachfMf n`�3
CLAIM FOR HOMESTEAD PROPERTY TAX
sE CREDIT /STANDARD DEDUCTION
; State Form 5473 (R2 / 5 -92)
INSTRUCTIONS: See reverse side for tiling instructions. � Il- t[•�•N �T V ""—
FORM /YEA .
HC10 7
.e) _l J ry\— T V l!(/_Y%A_ � LLY certify that on the 1 st day of March, 19L[
I j We)e) occupied as our principal place of residence the following described real property for which a Homestead Property Tax Credit is hereby claimed:
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.
It buying on contract, Fee Simple owner's name
APR 14 1996
Recorder's office where contract is recorded Record number Page
A
' PROPERTY DESCRIPTION
County, p -
Township
Taxing distr . t n ' wnship)
NON - RESIDENTIAL
VALUE
i s I�mbeb Q — Q Q
6 41
Legal description
If any portion of the residential structure or the land not exceeding on t) Sue that immediately surrounds that structure is used to produce income, describe the use and portion
of the property utilized to produce income.
PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES
County Township I County I Township
certify the above statements are true, correct and complete.
number and street city, state. ZIP Woe) _
ASSESSOR USE ONLY -
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON - RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements.
(1)
Other land
(2) .
Total land (line 1 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 pits line 7)
(g)
1 hereby certify the above is true, correct, and
,�mplete.
Signature of Assessor
Date signed
Wing action - Signature of Auditor
Date signed
19 _Pay 19
Lesser of 112 Homestead
Valuation or $2.000
ALLOWANCE
of Auditor / AI n ... ,. ( )i Inn _ i I Vdr 71711
STATE TORN`)'M,2:t.uur !RETAILER roEM 79-IA
Arrrrwro BY MMUE s onr.lrrn:.Tn.:cN rRf9lNnrL BY mcnEPAR.Thett(K L(1l'Ar COVEIMMIt rTA\`EM 6-1.1424I
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 eser for homestead fraud Homestead fraud causes higher tax bills for all:therefore.
® HEA 1344-3009 requires taxpayers who receive the homestead standard deduction to verify that they are eligible to receive the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
tiling+ This infnrmatinn will be kept confidential and ran only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
PART I: PROPERTY INFORMATION
Taxpayer Name Property Address
Balbach, Irene T Life Est Trust
423 Bradley DR
Ilaubstadl IN 47639
10832
IreneT Balbach
423 Bradley Dr State Parcel Number Legal Description
HAUBSTADT IN 47639-8157
26-23-06-301-000.641-009 0133-00641-00 SUNRISE ACRES 9
• PART 2:TAXPAYER 1NFOR\1ATION
Owner I First Middle Last
TH NC T, 64413AG �
- rag Address(number and sage[,city,state,and ZIP code) . . -- - _ . - Same is property eddress . — — —��-- .
Spouse First Middle Lau
Mailing Address(Number and street,city,state,and ZIP code) Same as property addrtss
Social Security Number(last 5 dieits) Drivels License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
smc
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 Signature Date
( )
PART 4:ADDITIONAL INFORMATION
•