Homestead_BellINDIANA SALES DISCLOSURE FORM SDF ID:
D. PREPARER
Preparer of the Sales Disclosure Farm
Address (Number and Street)
Title
Company
ee 2
Princeton IN 47670 812- 385 -8641
City, Stale. and ZIP Cade Telephone Number E -mail
Country -Ayre Inc
Seller I - Name as appears on can veyance document
9989 F Wag n•nn Roar
Address (Number and Street)
Haubsiadt IN 4763Q
T APPLY
THE SALES DISCLOSURE FORM MAYBE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
/ ❑ 1. Will this property be the buyer's primary /
residence? Provide complete address of primary
residence, including county:
Address (Number and Street)
Ciry, State ZIP Code County
❑ Q✓ 2. Does the buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
Address (,Number and Street)
City , Smte ZIPCode Cavnry
Q❑
3. Homestead
gy Heating /Cooling System
F1
❑✓
S. Wind Power Device
F1
Q✓
6. Hydroelectric Power Device
❑✓
7. Geothermal Energy Heating /Cooling Device
Q
8. Is this property aresidential rental property?
Q
9. Would you like to receive tax statements for this
property via e-mail? (Provide contact information
below. Please see instructions for more information.
Nat available in all counties.)
0?6 -11. 7 0�W01- ao9
------------
..
----- .........,.......... Email
v
STATE FORM 5356.(R3/8-10) TREASURER FORM TSIA
APPROVED BY STATE BOARD OF KLVOVT$NA PRESCRIBED BY THE OFPARTME1 OF LOCALOOVERNMEYTFINARF.IC 6-1.1-22-8.1
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPERTY _4 WNERS
101 N. Main Street Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
Princeton, IN 47670 more beneficial,there is more incentive than ever for homestead fraud.Homestead fraud causes higher tax bills for all;therefore,
HEA 1344-2009 requires taxpayers vdm receive the homestead standard deduction to verify that they arc eligible to receive the
di FILET', benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
L\s filings.This information xill be kept confidential and can on y 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 INSORMATION
MAY 5 2011 Taxpayer Name Location Address
C Bell, Brenda H
• 578 S 91h AVE
GIBSON COUNTY AUDITOR HAUBSTADT 47639
t 11281 =
IIIDI DI IIIDDIDDIIIDI mil_IIDIDl ii__vim I_iiiiiDII]II-IDI
Brenda H Bell.
518 S 9th Ave
HAUBSTADT IN 47639-8238
II"'I'II'I"'IIIIIIIFIIIIIIrtIIItlFtllrlltlrltlllltlllll""rill State Parcel Number Legal Description
26-23-06-200-000.807-009 /ALTE DEUTSCHE STADT 26PT UNIT 4
A
=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 - -- - - - - c P.AR"'2: TAXCAifl N -ORn .17IQN _ _i._. _ _
• ..-r 1 First Middle _ - - — - Last_
Brenda N. ,Dell
Mailing Address(number and street,city,state,and ZIP code) Same as property address
5--/ g S, qth 4ve. /Iau6sftd-f iN X7103q
Spouse First Middle Last
0eCeQSedi, •
Mailing Address(Number and street,city,state,and ZIP code) 0 Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(please specify in Part 4 below)
I I I I I I I I I star
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 l Si Date
( )
PART 4: ADDITIONAL INFORMATION