HomeMy WebLinkAboutHomestead_Coomer (19)INDIP.NA SALES.DISCLOSURE FORM SDF ID: � Pa e 2
: U'3R�E s
Rav M:.Drulev Attronev No. 475&26
PreporeroJNe Saln DLrdasurc Form Ttle �
1
505 N. Cfiurch Streel. P.O. Box 146 Law OKce of Rav M. Orulev
Addrm /Nvmber aM Street) Company
Fort Branch. IN 47648
�SELI�E GR'A'�NrTf2f2 iS'�° , ' - - q
Delie R S ee Frankie Hart
Sdfer I� Name m appean on [mveyvntedorummt Shcer 2- Namr as ayyeors on conveyvnce do�vment
1007 S Hall 4700 F Riversidw nr
Addrm(Numberand5tree[) ppdres(Numbeiand5treelJ
Princeton. IN 47670 Fvansville IN 47714
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Under penaities of perjury, I hereby certify tha[ this Sales Disclosure, to the best of my knowledge and belief, is true, correct
ancj.�q�te as requir� iaw, and is prepared in accordance with 6-1.1-5.5,; Re Prope ales Disciosure Act'.
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SignaWre o/Sel o �namre�
Frenkie Hart O6l042010
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` .� ' :� ,GR�YN�E� S ,�AP',�L-' AT10�I; DR�'FiROP;EFLsT��+UEU'IiCT-POl7S�DEN;I�.[Fsi'�A�I.�I ITiE_MS�,THTdTs�F3 . '
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9uyer7�Nameasappmn ryvncedocvmml Buyer2�Nameosappearsonronvqvncedotumml
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Addrat(NUmbe�andStrceQ AdArct(Num6erandStreet)
Princeton IN 47670 �
Gry, Smt4 a�d LPCade liry. Sma, ond7JP Code
E�mvfl R E-mall
TNESALFSOIS[LOSLRHiORMMAYBEUSEDTOAPPLYF00.CERTAlYDE0UR10NSFORTHiSPROPE OFTNOS TAPPLY.
YES NO CO\DRION Y NO COYDRIO.Y '
Q � 1. Will [his property be the buyer's primary 3. Homestead
residence? Provide comple[e address of primary � 4. Solar Energy Heating/Cooling System
residence, including county: �
9nR N T nth S rr t S. Wind Power Device
Addrar(Numberand5treet) ❑ 6. Hydroelec[rit Power Device
Princeton IN 47670 Gibson � 7. Geothermal Ener� Heating/Cooling Device
�Ciry mteLPCade Caunry
� 2. Does [he buyer have a homes[ead in lndiana to be � g• �s this property a residential rental property?
vacated for [his residence? If yes, provide ❑ 9. Would you like Co receive tax statements for this
comple[e address of residence being vacated, property via e-mail? (Provide con[act informatlon
intlu mg c'�ouu�� ty: 6elow. Please see insWCtlans%r more injormation.
2 1 1 �� M a f�e m.�.1. � In Not availa6le in all countles)
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!�drar(Num6erand Yee[J
r h1'�- �l� �. �`�7G �J G;bsati a/.�-�� � a�Z� 3az7 '�/ 7a D� �
�ry, Smle LPCOde Covnry
Pnmarypaperty owner rontuat name Email
Under penalties of pery'ury, l hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
being �led
S�qn reo/Byer7 Signanfrea(Bvytrl/Spo¢se
ne���.�vi i r �,..e. OR/04/2010
Lat[SdigittoJBuyer7Driver's SWte Las[SDigi[tofSocialSecuriryNum6er Las[SdigitrofBuyrrl/SpouseDriver's State LastSDigiuo/SotialSetunty
License/ID/OtherNumber Num6er License/ID/OUerNumber
, eibson County Auditor
- - 101 N. Main SUeet
Princeton,IN 47670
FILED
— MAY 1'1 2011
= C.J.N�
` GIBSON�COUNTYAUDITOR
1622 .. : .
SiAiE iORM
TRFaSIRERiU0.NlS1�
Individuals and married rouplcs are limitrd ro one homesuad standard deduction. As the receip[ of this dttluction bewmes
mare 6cneficial, ihcrc is more incentire ihari n�er for hamestcad (aud. Homestrad fmud fauses highcr tax 6ills for all; �hcm(om,
HEA 13M-?009 mquires taxpayrn atw recene the homestead standard deduction to �xrify tha[ [hcy are eli@ible m recei�x the
benefit end to prm�ide addilional idrnuf}ing information necessary lo allux' cowry gacrtunenl to bener monitor homestcad
filinss. lltis infortnation will bc kcpt eon(drn[ial and ean only bc aacsud W autharized eounty afficials. Thc Ihparmirnt af
1_acal Goremment Finance w'ill use ihis infomtation m creatt tools ehat will help counn� officials eliminate homestead fnud.
'• 1 �
Taxoayer Name Location Address
Hyneman, Dealie R/ Frankie Hart
Michael Coomer
208 N 10th St
PRINCETON IN 47670-1128
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II�I0�11��III QII �I III �IIDI DIi101�l111�
208 N 10TH ST
PRINCETON IN 47670
I ullull�l�ll I�IIII
State Parcel Number Leqal Description
26-11-12-203-000.472-028�� 137
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
u
Addccss (number and strcet city, state, and ZIP codc)
..
5 digia)
m Number (lazt 5 dir,its)
CooKe✓'
Ssme as pmperty addras
2 I N IS�.
� Same as property eddress
speciry in Part a below>
undersigned certifies, under penalty of perjury, that the above and foregoing infortnation is uve and cortect and that he or she is eligible m
�e the homestead standard deduction on this propeny. Each undersigned also understands that, by claiming additional homestead deductions
�fully, he or she may be liable for back ta�ces and subs[antial financial penalties. -
� g� �, Date Telephone
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