Homestead_AkinIbrJIANA SALES DISCLOSURE FORM SDF ID: Page 2
1D.- •PREPARER_�.- „±.-'. m`it�'. .•3?�3t s,.,, `."�''�...'.e c+ `�.i :':' ..;5 ::. '.",A.,,r- i'u'�.. ;.R, -sl? - ?r�" _- :_: -'F. _
Christopher C. Wischer Attomey - Petitioner
Preparer of the Sales Disclosure Form Trtle
20 NW 4th SUPO Box 657 Bamberger, Foreman, Oswald & Hahn, LLP
Address (Number and Street) Company
Evansville, IN 47704 812 -025 -1591 cMscher @bamberger.com
Ciry, State, and ZIP Code Telephone Number Email
E. SELLERS GRANTOR S - ` r
Larry R. Deweese
Seller 1 - Name as appears on conveyance document
Seller 2 - Nome as appears on conveyance document
100 W. Haub St.
Address (Number and Street)
Address (Number and Street)
Haubstadt IN 47639
Under pena es of perjury, 1 hnppy e.ptff that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and cam a as requi �nd is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ".
Sign tore Signature ofseller
Larry R. Deweese
Printed Name o Seller Sion Dow [MMIDD Printed Name o Seller Sam MM DD
F. BUYERS . GRANTEES _;APPLICATION FOR PROPERTY-TAkDEDUCTIONS IDENTIFY -ALL ITEMS THAT APPLY:,^
Marjorie Akin
Buyer l Name as appears on conveyance document
Buyer Z -Name as appears on conveyance document
107 W. Gibson St.
Address (Number and Street)
Address (Number and Street)
Haubstadt, IN 47639
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDITION O CONDITION
❑J ❑ 1. Will this property be the buyer's primary
3. Homestead
residence? Provide complete address of primary
Lt:l- 4. Solar Energy Heating /Cooling System
residence, including county:
E) S. Wind Power Device
107 W. Gibson St.
❑ a 6. Hydroelectric Power Device
Address (Number and Street)
Haubstadt, IN 47639 Gibson
❑ 7. Geothermal Energy Heating /Cooling Device
E] 8. Is this property a residential rental property?
City, Saw ZIP Code County
E] J❑ 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
0 ❑ 9. Would you like to receive tax statements for this
complete address of residence being vacated,
property via e-mail? (Provide contact information
including county:
below. Please see instructions for more information.
Not available in all counties.)
-/'�
M ki� (T-7 I �—"•' I matj:e-3@hotmaii.com
Address (Number and Street)
City, State ZIP Code Counry
Primary praperry owner contact name E -mail
-.TAU FORK S'w al)/,10) Trossu Rut IO LM IS1A
.V%IO'EDt11 iATE DO WO OF Ail(*NT\Y' FRISCILtDm'Mk OIPARIMEST OF IICV.COVLK■tF'I lh4NEIC tr:.Ir`ai
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS':.
101 N. Main Street Indiridua6 and married couples are limited to one homestead >inrwlnrd deduction.As tte receipt of this deduction becomes
Princeton, IN 47670 more beneficial.there is more incentive than eccr for homestead fraud.Homestead fraud causes higher tax bills for all:therefor:.
1� H 6\ 1344-2009 requires taxpayers who receive he homestead standard deduction to serify that they are eligible to receise the• benefit and to pro.ide additional identifying infrmatin necessary to allow county government to better monitor homestead
filings.This information will be kepi confidential and can only be accessed by authorized county officials.The Department of
Local Government Finance will use this information to crtmtc tool;that will help county officials eliminate homestead fraud.
PART l:PROPERTY INFORMATION"
Taxpayer Name Location Address
_ Deweese, Larry
107 W GIBSON
HAUBSTADT IN 47639
785
1niii III I II I I 1111� III I � III II1 I11�[ II II I II MARJORIE AKIN
107W GIBSON F .,
HAUBSTADT IN 47639
State Parcel Number Legal Description
MAY 10 202 26-19-31-301-000.055-009 ORIGINAL PLAN 57 PT/58 PT
GIBSON COUNTY AUDITOR
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.
. -- r „..._–__________—___________PAR 2:, A.vA I I - O'• ' -- --
,r I First Middle Last
Man r�o Al\vt Ak-to
Mailing Addrestunber and street,city,state,and ZIP code) Same as property address
F is
0 i 1/Al &ihc7ng1 8-- -b�:l� /- I k '-f l ii /?
Spouse First Middle Last
Mailing Address(Number and street,city,state.and ZIP code) 0 Same as property address
Social Security Number(last 5 digits) Drivels License/State ID Number (las:5 digits) Other(please specify in Part 4 below)
I I I I I state
• 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
unl fu ly,he or she may be liable for back taxes and substantial financial penalties.
CA nu idnature /}, Date
II
( )
- PART 4:ADDITIONAL INFORMATION.