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Homestead_RichardsonINDIANA SALES DISCLOSURE FORM SDF D.PREPARER Steven L. Whitehead rerof the Sales Disclosure Form 111 N. Hart Street Address (Num ber and Street) Page 2 Attorney Title Company Princeton, IN 47670 E -mail f*. E. SELLERS GRANTOR(S) Karla J. Richardson Seller 1 - Name as appears on conreyo nce document Seller 2 - Name as appears on conveyance docunnenr P. 0. BOX 72 Address (Number and Street) Address (Number and Street) Mackey, IN 47654 City, Stale, and ZIP Code City, Seale, and ZIP Code E -mail Telephone Number E -mail Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and complete as req tred by law, and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". . C(, L Sngnamre olselleq Signature of Seller tQ K_AyLa 171 c 14 P 124b SD 1- OY WfSI/GRANTEE(S) - APPLICATION F EDUCT Mark R. Richardson I - Name as appears on conveyanre document —a (Number and Street Mackey ) IN 47654 DO?. State• and ZIP Cade Telephone Number E -mall THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR YES NO CONDITION Q ❑ 1. Will this property be the buyer's primary residence? Provide complete address of primary residence, including county: 6969 S. Division Street Address (Number and Street) Mackey, IN 47654 Gibson City. State ZIP Code County ❑ ❑ 2. Does the buyer have a homestead to be vacated for this residence? If yes, provide complete address of residence vacating, including county: Address [Number and Street) Cim. Stale ZIP Code County Buyer 2 - Name as appears on conveyance document Address (Numberand Sveer) City. State, and ZIP rode I .l 5 IDENTIFY ALL OF TH OSE THAT APPLY- 3. Homestead .ai ❑ 4. Solar Energy Heating /Cooling System ❑ ❑ S. Wind Power Device ❑ ❑ 6. Hydroelectric Power Device ❑ ❑ 7. Geothermal Energy Heating /Cooling Device Deductions. ❑ ❑ B. Is this property a residential rental property? Under penalties of perjury, l hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and mplete a required by I / Is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". AW Wature o(Buyeh Signature of Buyer2 MARK e. IQLu+f1(z 0rJ 7- 1108__ STALE FORM!3:(0)OW I HNI TRE%SntERIORM 75.-TA •- . •PRm'ED BY Mgt BOARD of AfrouNTS. nrxWAmaY nIr DEPMfle? (1F LIXt>L GOVERNMENT F ASCE MFLI-`_-t-t • Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS • 101 N Main , c PRINCETON IN 47670 Individuals and married couples arc limited to one homestead standard deduction.As the receipt of this deduction becomes more beneficial,there is more incentive than eta for homestead fraud.Ilomesteid fraud causes higher tax bills for all:therefore. • HEA 1344-2009 requires taxpa'rrs who receive the homestead standard deduction to verify that they are eligible to recei a the benefit and to provide additional identifying information necessary to allow county government to better monitor homestead - filings.This information will he kept confidential and can only be accessed by authorized county officials_The Dqunntent of Local Government Finance will use this information to create cols that will help county officials eliminate homestead fraud. -.y PART I: PROPERTY INFORMATION Taxpayer Name Property Address _ Richardson, Mark R P 0 Box 72 Mackey IN 47654 8660 Mark R Richardson P O Box 72 State Parcel Number Legal Description MACKEY IN 47654-0072 111111111 t l r l l l l t 11111111 l l l t 111111 l l t r l l r l l t 11111 I I,I t l t l l t l l 26-20-15-204-000.024-002/ 015-00024-00 PT NE 15 3 9.21 AC PART 2:TAXPAYER INFORMATION Owner I First +'I (� Middle + Last Ma of i �KDILrx 4 tcN4 -ciSO h g.Address(number and street city,state,and ZIP code) - — _- Same as proproperty address —� - -- -- . 0. QoX 7C f'laekev _N, 47 , 5Y Spouse First Middle Last Mailing Address(Number and street,city,state.and ZIP code) ❑ Same as property address Social Security Number(lavt 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below) saw PART 3:CERTIFICATION Each undersigned certifies,under penalty of perjury,that the above and foregoing information is toe 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 z Date 0.641/1 Spouse Signature Date Telephone ( ) PART 4:ADDITIONAL INFORMATION 0