HomeMy WebLinkAboutHomestead_Harpenaw STATE FORM 53559(RII3.10) TREASURER FORM TS-IA
APPROVED BY STATE BOARD OF ACCOUNTS,2009 - PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1-22-S.I
.:1MPORTANT.NOTICE TO HOMESTEAD PROPERTY OWNERS i-
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
�
duction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
causes higher tax bills for all; therefore, HEA 1344-2009 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 filings. This information
will be kept confidential and can 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.
114-"'rr ;l 9.1-',1`:.: 4: . `" .:"-. i+:.PARTI:.PROPERTY INFORMATION +-?-.' t. 'fi .°.i; . .
Taxpayer Name Properly Adores, Slate Parcel Number Leal Descriolion:
Erica Harpenaw 734 E BROADWAY 26-12-08-400-002.819-028 PT SE 7-2-10.03 AC NS
PRINCETON IN 47670 LOT 3 PT R3
Complete and return to: I®lE!l90Il9lIB 0l; !!aEEICR!!LM!!.'1ER!!!
GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670
im..1+s cep` 6` �:-' ' _'.PART 2: TAXPAYER INFORMATION '. -+ :i '
Owner 1 First Middle Last
Ev cci 1 Ann 1-la au
matting Address(nutter arid street.aty.state and ZIP Ede) Sane as Property address
Spouse First Middle Last
Mailing Address(number and sbeeL city,state and ZIP code) I I Same as property address
•
Social Security Number(last 5 digits) Drivers License/State ID Number(last 5 digits) 5419 Osier(Please specify in Pan I below)
new M . i h' _'PAnL43.C E R T 3 c 1 t'. fw r' (•.;C 1
r :,
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
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` 1\DIANA SALF.S DISCLOSURE FOR�I SDF ID 26-2009-1000146 �� Page?
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�� MICHELLE HAYNES BOSSE TITLE COMPANY c CLOSING AGENT
?repa'er oJrhe Sales Disclosure Fonn Tirle
507 MAIN STREET, STE 10 BOSSE TITLE COMPANY "
dddnss /.�'u+nber nnd SrreeQ Comparrc
EVANSVILLE, IN 47708 (
Cirv. Smre, nndLPCode Te(ephm�e:1'umber E-mcil
;+SELI�ER(S)/GRAi\TOR(S)]m..��:�.e�t, >�.~+3�; -s •�.4�'`s�`�,.��'i_�<�+a'�'��'.�'• �^ 3ts� x�"��.,R��z4� �x`�e.z�:`-r.'x..f
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COREY A REED
Seller -:\'amr as apyrars an convrymcr doauneN Se11er -:Vnmr ns nppears mr ronrecarue dncunren(
72 N GARDENGATE DRIVE
dddrecs (.\S�mber and SlmeD Address (.Vvmber mid S�ren)
HENDERSON.KY42420
£-mail Telryhane,Vumber E-mai!
IUnder penalties o(perjurr, I hereby certify that �his Sales Disclosure. to �he best of my kno���ledge and belieL is true, correct and
complete as required b�� la�c, and is prepared in accordance �citli IC 6-1.1-�.5, "Real Propert�� Sales Disclosure:�c�".
� 4 ; ��
iynpmre 'elfrr Signamrr ol Seller
���; A. U�� r�lc�l�;G�
Pnmed \' ne ofSe!!n .Sie i Onte (.lf.if;DUNl'F}% Prirrt�A'ame ofSe(/er Sign Omr (.I1,N.'DD/}7YY1
F.�BU•YER(S)/GR �\TEE(S) "�CPP.I;IC-ATIO� �FOR:DEDUC7I0\S)\ND CR�.UhTS°dDE\TIFI ALC ITE�IS{TiH;\T�APPLI�_x.,.`-�
_.D..:.. a �.,t ��._e. _e-s.- _.� _wrs....�ea��.- ._.. �-.. .4�..v.�r.•_ .� .'fr_.�. ..0 �:_t�-_ir-'_'.u.u�8.. _R+
IERICA HARPENAU
4u��er -,\'ame ar apprars on emn�n�anre dw:umeru Bqrrr -\'arrre m appean ort ronrr�nnce dxnmrnt
294 WESTERN HILL
ddd+'us /,Vumber ond StreetJ dddress (.\'umber nnd StreetJ
EVANSVILLE, IN 47720
Ciro. S�
TelephonrNumber E-mai/ TelephoneNumbtr E-mail
1'l1E S,V,ES UISCLOSUHE FOR\I �L�1' BC USED'I'O AYPI.I' FOH CER"GUS UHDUC'I'10\S PORTIIIS PROPERT}•, �pF \TIF\".�LL OF"f110SET11.4T
r; 1. \\'ill this propem� be thc buyer's primary re>idence? Provide r 3. Homcstead
complete address of primary residence, includine counry: �-; q. Solar Enerey Hcating/Cooling S}•stcm
734 E BROADWAY STREET r>. ��'�nd Po�ver Dericc
ddJrrss (:\'umbermidStreerJ jJ 6. Hydroelectric Po��•er De�-ice
PRINCETON, IN 47670 Gibson
(-i 7. Geothermal Energy Heatine/Cooling Devicc
Cip�, Slare, anJ7./P Code Co�mn•
r 2. Does the bu��er have a homzstead to be vacated tbr this �� S. Is this propem� a residen�ial ren�at propern-?
msidence'. If }•e>. proaide complete address of residence vacatin�,
includine coanta:
IdJ�'ess(:�'unibrrmul5lrer�J aG-ia-oP � - oaa. �di9- aa�
Ciry•, Smte. md LP Cale Canm'
n er pena hes o pequn�, ere y cerh y t at t �s a es isc osure, tu � e etit o m�• �no�r e ge an e �e , �s true, correct an
complete as reyu'red bc la���, and is prepared in accorJance ��'ith IC 6-1.1-i.5. "Real Pruperh• Sales Disclosure Act".
A' � �l A L4J AJ.,I�
���guamre of BIusI� Siymarm�e of Burer
�rirrx f-tarpPnac� C'�iC;�l ��n9
PrinleJA'mneofBye' SignDam(AfiUDD/}'Y}'Y) PriretzJ:\`mneofBuver SignDate(:171DDD/t7"}'}')