Homestead_Gaines INDIANA SALES DISCLOSURE FORM _ SDF in:_ 26 - 18 _ .1113067 Page 2
I REPARER''. .& ;' •'`1fr5 tr•^ 1 . • ..'•• `kg'+r-``i5' �F r ae'. ° +'.-L' lm•dr' ,.±;' `rr =3+z' ';.i =3
Meehan Napoli Closer
Prepare.of the Sales Disclosure Fann ritic
215 Chesterfield Business Parkway suite B • Netco
Address(Number and Street) Company
Chesterfield, MO 63005 877-776-3826 teams @netcotitle.com
City,.State,and ZIP Code Telephone Number E-mail
2 EY E L LER(S)%GRANTOR(SW o 7 .c+.-' * r : " •c - ',•e: :W•c,i:vY r , ,.-._•�s3'•' F i
Timothy A Gaines - - I Shannon G Gaines
Seller]:Name as appears an conveyance document I Seger 2-Name ec appears an conveyance document
827 West Drive � 527 West Drive
Address(Number and Street) Address(Number and Street) ,
Oakland-, IN 47660 Oakland , IN 47660
Under penalties of perjury,I here I • certify that this S ies Disclosure to the.best of my-knowledge and belief,is true,correct _�
and°u '- 1 e as Jett uired• y la • dryprepared in accordance Wiitth IC 64.1--5.5,"Real Property Sales Disclosure Act".
Sion• re of Seller Si ionutureofSi;Bor p /q
othy A Gaines ` - •-(f Jv a I Shannon G Gaines /c' X p
L
•
Printed Name of Seller • - Sian Date lxY D'tT rll Thin of Starry 'Sell - Si n Date M4.4/DD 'MI
i-FrtBI ER(S)%ci rANiTiEE(s)�aAt iEL[C%iTiION(F OR4PROPEtt ril l4TiF"DED-UGTIONSuWOENfflfF!1ti -s t 7I 'r,"IitorTrit- at• `Slays
TimothyA•Gaines - _ --17777-— - ': il: t
Buyer l-,Name as appears an conveyance document - - 'tiuyer 2-NW::uus appeiis on conveyance document-1'2827-West Drive JUL (�
• --Addrs(Number and Street) , • -- •--- I Address(Nun:hr.and Street) .. 1 ° LU10 1
: Oakland , IN. 47660 - (__ ._
• THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DPI)I' I I)NS FOa TH'C PROPERTY. IDENTIFY ALL OF41-105E THAT APPLY.
_YES- NO CONDITION YF NO _rcONOITION-
0. ❑ 1.Will this property be the buyer's primacy 7 \yr 3.Homestead
residence?-Provide complete-address of primary ! ❑ 4-.Solar Energy Heating/Cooling System
residence,including counpr. i ❑ 0 5:Wind Power Device
Address(Number and street).. ❑.. Z -G.Hydroelectric Power Device
IN i 0- 0 7.Geothermal Energy Heating/Cooling Device
.Ciry;Stare ZIP Code '.0111'9•
I ❑IL 8.is this property a residential rental property?
®l -- 2.-Dues the_buyer,have.a homestead-in Indiana to he •I ❑ ❑•
vacated-for.this residence?'If yes,,provide' 9.Would you like to receive tax statements•for this
complete address ofresiclence`being-vacetei, i , property via e-mail?(Provide contact information
- including county: i below.Please see instructions for more information.
I Not available in all counties.)
Address(Number and Street) ------- I /J 'j /�O/l
_ L.Tir..cthy/�G3nas.�h'.)'y�g"IDa- •J.J•t/ -`/•City.Stare ZIP Code ... Gana I •-- -l _ntar:name E-mail
- �nmut property mvnecco
D��1
Last digits of Buyer 7'Driver's Sou Lae,.S Dig ro aj SDrtal Sena N r ! r I 'Last Sdrmt otd}e 2/S-cu.e0 Driver's SW;e• -Lasts Digits of Social Security .
-License/ID/OHrer Number
` `-Au noel Lrcccse/ID/OtF'r i.7 inl,- -
iJ
CLAIM FOR HOMESTEAD PROPERTY TAX �( FORM YEAR
CREDITISTANDARD DEDUCTION
Soda Form 5473 (R715-0g
Presmibed by the Deperbnent of Local Goveffirnerd Financa
INSTRUCTIONS., See reverse side for Ning instructions.
J..'CIERM
CATM STAM T,
I (We) S. LI/I 111)11 U I ki NJI r-VIV LVk —%--L'w lw'4'j� ti y jwt on the 1 st day of March, 2D I (We) occupied as our principal place of reside
the following descnbed real property for which a Homesleacl ��a5 C" 's hereby daffned:
Are buying r tract
1 (We) owned t
Have a beneficial interest in the entity that is liable for the property taxes on the property and that owns the W8Wft js*;OW�nder a contract.
If buying on contract, Fee Sirnpde owner's name % I
PanYdeftatke where contradis recorded Record number Page I
J'-""" �V V. PRWEIVITOWWEE) BY,
r , �' 7 uAmiANTIN'OTHER COUNTIES'
-PROPERTY DESCRIPTION : ... ..
Canty
Tarrmlnip
7�
A � o"
V
Twang district (ciy lown, 1--#)
Township
F�ZP
Legal desctptn
s
o question.
Da7-,C)Co,
-W-7
Land not exceeding 1 (one) acre inwxxtiately
Property ❑ Mobile Horne (M (min
NR
lf arty potion
that immedattily dud shobture is used to produce incorne. describe the use and portion
—rol"
of the properly Lkkmd to produce
J'-""" �V V. PRWEIVITOWWEE) BY,
r , �' 7 uAmiANTIN'OTHER COUNTIES'
�:-'N
County
Toenatdp
7�
A � o"
V
County
Township
I hereby certify the above statements am true, correct and complete.
.'. I V
a
rnlw ano
r01' 0
I /'I I
' "'
�4!�-TRLJETAX,�..',',
ASSgi66'.VAWE
1'-"H'6VESTEAD-
7�
A � o"
V
ONLY
I
.'. I V
r01' 0
Land not exceeding 1 (one) acre inwxxtiately
surrounding residential improvements.
Other land
(2)
Total land (Ilene I pilus fire 2)
(3)
Residential ffrprom. ents or Annually
Dwelling
(4)
Garage
Assessed Mobile I Manutectured Home
Other improvements
(6)
Total irnprovarnents; (lure 4 through fine 6)
(7)
Thal value (fare 3 plus fine 7)
(8)
I hereby certify the above is true, correct and
complete.
SsnatureatAssessor
I
Date signed
Vartlying adJon - Sgriature of Auditor
Data signed
STANDARD DEWCTION ALLOWANCES
20_Pay2O_
Lesser of 112 Homestead
Valuation or M.000 $
- I I
f V - -----