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Homestead_Pond4 MntANA SALES MSfr OSURF FORM :nP In. Paee 2 -D.PREPARER Dan L. Reeves Attorney Sales Disclosure Form Title 'Preparcrofthe 116 S. Main Street Address (Number and Street) Company Princeton IN 47670 (8121385-8641 Ciry, State and ZIP Code Telephone Number E -mail ,E. SELLERS GRANTORS : - David I Pond Seller 1 - Name as appears on conveyance document 1761 S 725 E Seller 2 - Nome as appears an conveyance document Address (Numbwand Street) Frnnr'cro IN 4764[1 Address (Number and Street) ' of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and to to as req�lir by law, and is pr ared it accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". arixq a4 i namreaf ller Signature of Seller E 1/c,S ! 2 6 / 0 Printed Nameofseuer Sian to MM 0 Printed Name a Seller Sian Date (MMIDDIYYM F. BUYER S)/GRANTEE (S APPLICATION, FOR PROPERTY. TAX DEDUCTI DNS- IDENTIFY-ALL ITEMS THAT APPLY . , Christopher J. Pond Buywl Name as appears on ronveyan document Buyer2 Nameasappearsoaronveyancedocument 1761 S 725 E Address (Number and Street) Address (Number and Street) Francisco IN 47649 THE SALES DISCLOSURE FORM MAY HE USED TO APPLY FOR CERTAIN DEDUCT 10N5 FORT HISPROPERTS ^IDEWiTTA Of.THOIE THAT APPLY. YES NO CONDITION YES NO CONDITION [71 F1 1. Will this property be the buyer's primary ❑./ ❑ 3. Homestead-' residence? Provide complete address of primary . Solar Energy Heating /Cooling System residence, including county: ❑ ❑ S. Wind Power Device Rm W School Street ,/ . 6 Hydroelectric Power Device ❑ ❑ Street) Address(Numberand Francisco IN 47649 Gibson ❑ ❑✓ 7, Geothermal Energy Heating /Cooling Device ❑ ❑� B. Is this property a residential rental property? City, State ZIP Code County 2. Does the buyer have a homestead in Indian ❑ J❑ a to be ❑ ❑✓ 9. Would you like to receive tax statements for this vacated for this residence? If yes, provide complete address of residence being vacated, property via e-mail? (Provide contact information below.. Please see instructions for more information. including county: Not available in all counties.) ollo -t(3 -/ q -Z y/ -000-2-30 -oo Address (Number and Street) Ci ry, State ZIP Cade County primary pmperryowner Contact name E -mail V STATE FORM 53569(0.38-10) TREASURER FORM TS-IA APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1.1-22-8 1 .ai • • IM PORTANT NOTICETO HOMESTEAD PROPERTY ^OWNERS � '� � Individuals and married couples are limited to one homestead standard deduction. As the receipt of this 'eduction 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. tq rr i ' `TPARTITPROPERTY:INFORMATION Taspaver Name Procem'Address State Parcel Number Leval Description; Christopher.1 Pond 607 VI SCHOOL ST 26-13.19-201-000.230-005 PERKINS ADD 33PT/34PT/13/14 FRANCISCO IN 47649 Complete and return to: I®IIDQ]llEllD D]DDI .EDI IQ lllUU I.uIIE ___GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 PART 2i'TAXPAI'ERINEORMATION'•. ; �^1 + Owner 1 First Middle Last T l�Ylr15�6j°/er T - enc.( Mailing Address inurn and street,city,state and ZIP code) I✓ I�� /, -- Same as property address no Boy / r4n c;sco yX Y 9 Spouse First Middle Last Mailing Address grabber and street city,state and ZIP code) I Same as property address Social Security Maher(last 5 digits) Driver's License/Stale ID Number(last 5 digits) see Other(please specify in Part 4 below) gAll or • , ; : -PART3:CERTIFICATION." t- qe r t,' t ,^f>++: 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 1 Signature - Date ( ) - _ •. ,: ,1 PART:4:ADDITIONAL:INFORMATION, -