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HomeMy WebLinkAboutHomestead_Barrett `IsOsKKtKNKtK2*cG4�w Kimberly A. Lewis Office Manager jPreparer of the Soles Disclosure Form Tale 226 W. Broadway Broadway Title, Inc . ®Address(Number and Street) Company Princeton, IN 47670 812-386-1687 kim-bti @insightbb.con City.State and ZIP Code Telephone Number E-mail E SEELER(S)/GRANTORS -- s+ _,,-._�. g �'� .Y��i� tb :aaM7Fi -ue_.-s ' i. S :'&IV Kenneth E. Sollman, Sr . Seller I-Name as appears on conveyance document Seller 2-Nome as appears on conveyance document 101 Hull St . Address(Number and Street) Address(Number and Street) Haubstadt, IN 47639 Under penalties of perjury, 1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete a regl•ire b w,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". E, I - - Signature of Seller Signature of Seller . FNNG!• e . r ©8 o3 /oo' • rated '•..e of Seller '•n D..e{MM/DD/YYYI') Printed Name of Seller Sian Date(MM/Da/YYn1 tFfi=N. -ER(S)/GRANTEE(S) 'AP,RElCATiONI?OR!P'OP.ERTY;TAX^DEDUCTIONS IDENTIF.Y?ALUITEMSFTHAT AP,P.liY• ;_; _ -'`_._�;.:.: William J. Barrett Boyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 11570 South 150 W Address(Number and Street) Address(Number and Street) - . -- . . , N 47639 THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIO: 'I R THIS PROPERTY. IDENTIFY ALL OF THOSE TH• PPLY. YES NO CONDITION YES NO CONDITION ® ❑ 1.Will this property be the buyer's prim-ry ® ❑ 3.Homestead residence? Provide complete address If t rimary ❑ jj 4.Solar Energy Heatin: - Doling System residence,including county: 101 Hull St . ❑ Q S.Wind Power D' - e Arat{ s adt,t) IN 47639 Gibson eeectrcPowerDevice ❑ ® 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ j 2.Does the buyer have a homestead in Indiana to be ❑ 8. Is this property a residential rental property? vacated for this residence? If yes,provide ER ❑ 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.) Address(Number and Street) 1 VN\,okra.'. �t�n-�c\ Lib ant)_\ 5,\-CO.l` ,Q.� City,State ZIPCade County Primary property owner contact name E-mail • STATE FORM HMO(R3 11-10) .TtEASLRFA FORM TS-IA • APPROVED BY STATE BOARD OF ACCOUNTS.L'Ol IRESCRIBFD BY THE DFIARME\T OF LOCAL GOVLY\MEVTRMA`a ICS-1 t-lldl Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS 101 N. Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction bdomes Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore, re are HEA 1344-2009 quires taxpayers who.receive the homestead standard deduction verify that they a eligible to receive the i I L E D 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 Depamnent of Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud. PART 1: PROPERTY INFORMATION APR 2 7 2011 • Taxpayer Name Location Address Barrett,William J C_3.nr 101 HULL ' GIBSON COUNTY AUDITOR RAUBSTADT IN 47639 2332 ' • William J Barrett II.10111101110111001111_II.011011011101011011_11:1111/01 1181 b11311.11011011 101 Hull St HAUBSTADT IN 47639-8119 ' Ilrl'Ill'IIIIIIII"II'II'IIIII!'I'III'IlI'IIIIIIIIII'IIIIIIIIIII' .. State Parcel Number • LegalDescription • 26-1836-402-000.381-009 /WEST HGTS 1ST ADD 23/24 , . . 4/ 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. ..III ( . First o . Middle 1 Last _ VV 1 1\c..Qx(Y\ C' SQ.e� 10000Q� ` n Mailing Address(number and street city.state,and ZIP code) I . d Same as property address \ C) 1 \-\o\\ -) . Spouse , First Middle Last Mailing Address(NI mlxr and mcet city,state,and ZIP code)`--_ T ___.� t'samc as property address---a'--,— , —--r.— Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) u Other(please specify in Pan 4 below) - < 1 I I I I I I I I suet 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 e "'^ CLAIM FOR HOMESTEAD PROPERTY TAX STANDARD /SUPPLEMENTAL DEDUCTION State Form 5473 (R12 16-09) Prescribed by the Department of I=] Government Finance INSTRUCTIONS., See reverse side for filing instructions. CERTIFICATION STATEMENT, -74 M* certify that I (we7vnzupeuem W#1oirrA(%iT)R I (We) place of residence or am (are) buying the Allowing described real property for which a Homestead Property Tax Standard Deduction is hereby claimed under contract on the date this application is filed, (date of filing): ❑ I (We) own ❑ Am (are) buying under recorded contract ❑ Am (are) entitled to occupy as a tenant - stockholder of a cooperative housing corporation ❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust INFORMATION CONTRACT ••r r If buying on contract, Fee Simple owners name Recoidels office where contract is recorded Record number Page PROPERTY DESCRIPTION County Township d ou" (city, town, township) Pamel number Legal desaipdort S ay Is a property in question: eal property ❑ Annually assessed nrobile home (IC 6-1.1 -7) any portion of the residential structure or the land not exceeding one (1) acre that immediately surtounds that structure is used m produce income, describe the use and portion If the property utilized to produce income. a6 -r8 3l0- yo a -000. 38/ -00 9 PROPERTY OWNED BY CLAIMANT C Cauml Township ount' Township I hereby certify the above statements are true, correct and complete. S� na'q� turn of claim ' Address(numberand street, city, state, and 7IPcode) ��� lo\ H \ f I r . , Mill, r TRUE T VALUE ASSESSORU SE ONLY TRUE TAX VALUE Land not exceeding 1 (one) acre immediatety '.- •'' - surrounding residential improvement.. !(4Other land Total land (line 1 plus line 2) Dwelling �+�'S••.+r - '- Residential improvements or Annually Assessed Mobile 1 Manufactured Home Garage -'�-�' (5) improvements (6) mprovements (line 4 through line b) (7) [0ther value (line 3 plus line 7) (6) Signature of Assessor Date sgned (month, day, year) by certify the above is We, cortect, omplete. Adh yg aclkn - Sigramre of Audimr Data signed (month, day. year) STANDARD • r 20 _ pay 20 _ Lesser of 60% of the assessed value of the homestead or $45,000 Nntmthstanding any otherprovision, the sum at the deductions pmvided in IC 6- 1.1 -12 to a mobile home that is $ rot assessed as real property or to a manufactued home dust is not assessed as real pmpery may not exceed M& hall (1/2) of the assessed slue of the mobile home or manufactured home. Date signed (month, day, year . nature of Auditor V