HomeMy WebLinkAboutHomestead_Collins (9)INDIANA SALES DISCLOSURE FORM SDF ID: ' Paoe 2
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Jennv Sherrill Customer Service Reo-
Preparer of tne Sales D'udosure Form TiNe
6525 East 82nd SveeL Suite 110 Staieveide Title Comoanv. Inc.
Acdress (Numb�• and SveeQ Comoanv
�Indiana�olis. IN 46250
E-mail
;E� SEI:liER(S GRANTOR Sl. � - _ -' ` _ -
=Pd?•al Hnmo I nan Mnrt�age (:amnraiinn
Seller ]- Nam^ as appears on ronvetwnre dotvment Se(/er? - Name as appmn am m�vevance docum=n:
50(1!1 olann ?arkwav
ddaress (NUmber a�d S:ree[) Aadress (A'vmuer onC Svee.J
Carrnllinn TX 75�10
Cim. Smre, and ZI^Code CiW, Smre, nnd ZIP Code
E�mail TeleononeNumuer E-mail
Un pe ties of perjun', I hereby certifi� [ha[ this Sales Disclosure, [o the bes[ of my knowledge and belief, is true, correct
d com te as required by law, and is prepared in accordance with IC 6-1.1-"s.5, "Real Property Sales Disclosure Ac[".
.unamre ofSeller Siunamre o(Selfer
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=F.=,BUYER GRANTEE S �-�APPtiIC TION�FOR�PROPERT.1 TE�.l'�DEDUCTIONS-'1DENTIFY'AL[i1TEM5''THAT.�aPPLY: _ -
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Em�e:]�Nameaso evrsonronvn� [edotumen: �.�/(�� Bvre:?-�1'ameatappearsomm�vevunc=uocumrn:
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.�^oioneh'um e: c-moil TeleononeA1�muer E-mail
HE SALES 06CLOSURE FORN Aidl' BE USED TO APPL1' FOR CERTAIK DHDURIONS FOR THIS PROPERTI'. I DEYTIFI' dLL OF THOSH THAT APPLY.
IYES 50 CO\DITIO\' I 5"FS 0 CORUITION
� 1. \�Vilf this oroperty be the buyer's primarv ❑ 3. Homestead
residence? Provide complete address of primarv � �4. Solar Energv Heating/Cooling System
� `� e�e�incJ ingcoun�i� ��� I�—
U J ' ❑ L'J ��'Vind Power Device
�'aress(Nvmu=: an sPee:� �� I,�„ ^� ❑ � 6. Hydroelectr�ic Po�ver Device
P�i ���2�ok- �n ��7l�?o r��o i � L/�' 7. Geothermal Enera� Heating/Cooling Device
CiqySm.eZiPC = Counq� f y
� � Does the buyer have a homestead in Indiana co 6e � �CJy 8• Is this property a residenaal rental property?
vacated for this resid=nce? If yes, provide ❑ yJ 9. 4VOUld you lik= to receive ta.a s.at=mencs for this
comolete address oi residence bein� vacaced, properm via e-mail? (Provide contoct information
including counn•: below. Please se_= instrucions jor more injormation.
Not available in all rounries.)
Adoress (;: um6er and S:ree[J
Gn, Sm:e Z1P Cocr Counn•
Primap� nrooem o�vner conmct name i�moil
Under penalties of perjury, 1 hereby certif}� tha[ [his Sales Disclosure, ro the best of my knowledge and belief, is [rue, correcT
SfATE NRM 13569 (R1B-10) TRFASUItER FOAM iS-IA
APPRO\'ED BY SfATE BOAFD Oi AC('OLnTS,'_OD9 PftFSCIUBED BY THE DEP.VtiTf�lT OF LOCAL GOVER.\MEhT Fl.�',1�\CE ICbl.l-_'_'F.I
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Individuals and married couples are limited to one homestead standard deduction. As the receipt otthis
deduction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
s�auses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers «�ho receive the homestead
d"ard deduction to ��erifV that they are eligible to receive the benefit and to provide additional identify�ing
information necessan� to allow counh� government to better monitor homestead filings. This information
will be kept confidential and can onl}' be accessed by authorized county officials. The Department of Local
Go��ernmeut Finance will use this information to create tools that �vill help county officials eliminate
homestead fraud.
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Taroarer \amt Pm�xrb' Addrcu State Parcel Svmber Leeal Desrriorion:
Brian W Collins 717 E EVANS ST 26-12-07-002-003.268-028 PT N SE 7-2-10 .40 AC
PRINCETON M 47670
ComP,eteQnd.etu�n ro: ��u�u���mu�m�mmm�Q�DU����mu�m�
GIBSON COUN7'1' AUDITOR. 101 N�tAL\ PRL\CETON I\ 47670
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MaJirg AtlNess (nwCC anE svee� dry, state anE ZIP mde)
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Each undersigned certifies, under penalry of perjury, that the above and foregoing in(ormation is true and correct and ihat he cr she is aligible to receive the
homestead standard deducfion on this property. Each undersigned also undersfands that, by Gaiming additional homestead deductions unlawfully, he or
she may be liable for back taxes and substantlal finandal penaltles.
Oxnc 1 $ipnaWre � ��e Telepl�one
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$i¢iatlue Dat^ ieleplione
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• NOV 9 2012