Homestead_Slinker INDLSNA SALES DISCLOSURE FORM - SDF ID: 143 Page 9
D:PRE'_AP<ERs --, Y
' e em• ill=g TM'.�_C t t So _ Closer =
• Preparer of the Sales Disclosure Farm - Title- '
420 Main St, Ste. 1307 Expert Title Services
Address(Number and Street) Company
avansville, In 47708 812L 437-5700 closingdocs @expertts.com
Ci%Since,cad ZIP Code Telephone Number
E-mail
E?SELLER S/GR%i.NTOR(Sa r`'t' =k""i-n 3s- uY a :.-c _ 1. 5 S ._ - °vr. SLtv :s.s.°fr1ts_1...,�s-...c. s4iaj:
Seller I-Name as appears on c-nveyonce docu... Seller 2-Name es appears on conveyance document
IDl SBroodv1eW �irJ, e Di- . .
ddresr(Numb and Street) Address(Number and Seeec)
• r i roc.ct o n .-1-n . c/ 761 L)
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is ti e,correct
aq.i complete qs requir by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
i;r""'C of Sells�(,CQ � � a Signature a/Seller
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ill ti A- es LI , b '
Printed et ..._emigra Sian Dace N14/00/Yri9) P .ed Name ofS lie Sian Dere DeN/OO(YlY)
`F:2 t R.S:`CRANTEEfSMicRPLICATIONFO.`DEDUCTIONS:4ND-CREDITS "iDEENTIFy ALCITEVS.-THAT 4PPi::'.-:
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p. • P. E
Buyer 1-Name as appears on conveyance document e:2-Name as appears on conveyance document document\.S I 6 u� [ 7 W ••
a^c _
,% A ^ Address(Number and Street)
S l:-�J
FOR a na THOSE THAT APPLY.
YES NO CONDITION J
❑ 1.Will this property be the buyer's primary - ❑ ❑ 3.Homestea '
residence? Provide complete add.-ess of;rimo.y u u otar Energy Heating/Cooling System
residence,in ningcounty: ,_,,
tobt/g e, s f"t t'fLI CV ❑ \J 5.Wind Power Device
(Number and Erect) ❑ 6.Hydroelectric Power Device
Cry,Sate ZIP e / ❑ 7.Geothermal Energy fteatlng/Cooling D=_vice
County
❑ P Does the buyer have a homestead to be vacated for ❑ Ll °�Is This property a residential rental property?
this residence? If yes,provide complete address of
residence vacating,including county: ten// .^f /may),
Address(Number and Street) (/ECG /- - U 1 -CVO .oat7 —(Jas-
^)
•
® - .. - _• •
mit FORM!!wd0./•-nI TREASURES EWRY:}IA
APPROVED BY',fit BOARD Of HYTIITS.TV PRFANDEO BY Tilt DEPARneaeY LExL'1t I:VER.0,,rwr FINANCE r r.RI--rat
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 incentnr than ner for homestead fraud.homestead fraud causes higher tax bills for all:therefore.
® . HEA 1344-3009 requires taxpayers who retire the homestead standard deduction to verity that they are eligible to recebe 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 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 1: PROPERTY INFORMATION .
Taxpayer Name Property Address
Bolin, Forrest E/Betty Trust
R 113ox 202 (r I 1 Ch
Francisco IN 47649 (�
1710 p4�/ \AVy
Luann Slinker
6048E Hwy 64 State Parcel Number Lena!Description
FRANCISCO IN 47649
26-13-18-403-000.028-005 012-00028-00 PT SE 18 2 9 1.2127 AC
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.
PART 2:TAXPAYER INFORMATION
Owner I First Middle Last
Ltkaton SL.Inleer
g Address(number and stmt.city,state,and ZIP code) 0 Same as property address
0y 8 E. S74TC- 7-4W lay ) M4Ncrsco / to 4-749
Spouse First Middle Last
NA
Mailing Address(Number and street,city,state,and ZIP code) 0 Same as property address
Social Security Number(last 5 digits) Drivers License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
Sr
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
•
1I 11
u
CLAIM FOR HOMESTEAD PROPERTY TAX
STANDARD /SUPPLEMENTAL DEDUCTION
State F.5 "(11121609)
I' prermp� M art Depam+x4 a l� Govanae Fnace
INSTRUCTIONS: See reverse s le for Nirg inatrrcrions.
,6
AUG 1 4 7nn9
CERTIFICATION STATEMENT
I (We) Ltann Slinker oemN that I I.) az my ( pal
place of residanrs or am ( are) buyirg the following described real Property for w a Homestead Property Tax SIar�EadoO�e
under contract n the date this aopbation a fried, AUgUSt 14, 2009 (date of Nirg):
❑/ I(We)own ❑ Am (are) drying under recoiled contrea GIBSON COUNTY AUDIT
❑ Am (are) entitled to oocroy as a tenant- smckholder of a cooperativa housing corporation
❑ Have A benefidal interest in the bust or the right to omlpy the property under the te. of a qualified personal re5idnce bust
CLAIMANT'S INFORMATION
a h"kg on ox a Fee sivaae o . name
Remrdrls d6ce dammed Record ranEer Page
PROPERTY DESCRIPTION
C.-ty
Tarslvp Tams dpaid (a,, ft,, fcx~ b)
Gibson
Center Francisco
Pa
Leal dssapom
I hMa
prtpery InO s
26-1318. 403-000.028-005
012-00026-00 PT SE 16 2 9 1.2127 AC
Q Rey poppy Armuyh sssessal herdic acme (lC 6r.1 ->)
6 anY porter a the resaeNy wwu<p the bpd era eaceedvg one Itl ap<Mal vmsGatay vnpuds Mat ibutave s vsM b prpdura vans. dvmae the uze and potion
a as proparY Wl¢ed m pmBaL franc.
PROPERTY
Cathy TearWip
OpaaY Toanyvp
I hereby cemty the above statenrems are trie. correct and complete.
Sipnaaw of dairma
Addrm (armeerena seen. rat: stab. andL cede)
6048 E State Road 64, Fancisco, IN 47649
HOMESTEAD NON-RESIDENTIAL
ASSESSOR USE ONLY TRUE TAX VALUE JASSESSEDVAL.UEJ
lane not exceedtrg i lnxxl ape hmmeetawly
...W.g msldenUal ems. (1)
Other land
(2)
Tool Iand (fim I phrs 6 2)
(3)
Dxetllr�g
(4)
Realdemlal lmpmrm�enb wAnnualV
Aaaessetl Ydilk I Ymuhciurtd Home
exaite
(5)
Other Mprevanenn
(6)
Total Imlaovemerrts (6rra 4 through lim 6)
(7)
ToW value (flair 3 php tier 7)
(8)
1 hereby centity, the above Is true, correct,
Signers aASesm
Doe cpxaf (own. day, year)
and complete.
ve t,,, asm. swaam dA
STANDARD DEDUCTION ALLOWANCE
Dc yPsd prsrun. day 1eM
20 pay 20 Lesser of 60% of the assessed value of the homestead or S45,f1(10
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