Homestead_DeckardDISCLOSURE
SDF ID:
D:.PREPARER.' c '4A
Dan L. Reeves Attorney
Preparer of the Sales Disclosure Farm Tide
_ S. Main St.
�ess (Number and Street)
Princeton IN 47670
City, State, and ZIP Code
WINIFRED SUE MARTIN P RS 2E2 EST MAR IORIE A HAYDEN
Seller I - Name as appears on conveyance document
nRn-t m IMN- coRINGFIE1 D RD
Address (Number and Street)
SAT VFRNON IN 47620
City, State. and ZIP Code
,
of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and consP� ete as required b I , and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ".
'gnamre of5eller Signature of Seller
I -Name
Address
- U
Ber Sian Dale (MmIDDIYYM
RANTEE S ` APPLICATION FOR PROPERTY TAX
ECKARD
oppears anveyance document
D
and Street)
FN 37083
Code /
and Street)
City, State, and ZIP Code
document
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
YES NO CONDRION Y
Y
✓❑ ❑ 1. Will this property be the buyer's primary ❑
❑✓ ❑ 3. Homes
residence? Provide complete address of primary /
/ 4. Solar Energy Heating /Cooling System
residence, including county: ❑
❑ ❑✓ S. Wind Power Device
❑ ❑✓ 6. Hydroelectric Power Device
Address (Number and Street) ❑
❑ Q 7. Geothermal Energy Heating /Cooling Device
City, State ZIP Code County
® ❑ ❑
❑ ❑✓ 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide ❑
property via e -mail? (Provide contact information
complete address of residence being vacated, p
below. Please see instructions far more information.
including coxnt b
Not available in all counties.)
� l
6_ a_ Op •�� -oog
Cdr ss (Number and Street) ` 6
City, State ZIP Code County E
Email
Pn'mory property owner contact name
Under penalties of perjury, I hereby certify that this Sales Disclosure, t
to the best of my knowledge and belief, is true, correct
and complete as required law and is repared in accordance w
with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act "
Spouse information, So al ecurity a Drivers License /Other numbers are not necessary if no Homestead Deduction is
being .1
(y— '`-
Iamre a /Bvyerl /// / S
Signature ofliuyer2 /Spouse (
WII I IAM W DECKARO t
c\
STATE FORM 53509 dU/&la) " - TREASURER FORM TS-1A
APPROVED BY STATE BOARD OF ACCOUNTS.3009 PRESCRIBED BY THE.UEPARTME\T OF LOCAL CAVERNMEVT FINANCE IC 6-1.133091
Gibson County Auditor IMPORTANT NOTICE TO HOMESTEAD PROPER73'`O��FNERS
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 who receive the homestead standard deduction to verify that they are eligible to receive the
• benefit and to provide additional identifying information necessary to allow county goremment to better monitor homestead
filings.This information will be kept confidential and can only be accessed by authorized county officials.The Depanuent of
Local Government Finance will use this information to create tools that will help county officials eliminate homestead fraud.
- PART 1: PROPERTY INFORMATION -
T� T) Taxpayer Name Location Address
_ y L - Hayden; Marjorie A
JUN 2011 108 Ben
I'1 Haubstadt IN 47639-8120
TW I am W Deckard GIBSON CO OR INIIII-IIII II I1-IIIICII_IIIJIIII 101 III II-II III II111101 1111111- I I II
108 Ben St
HAUBSTADT IN 47639-8120
Illlltlltlllt 1111"littIIIltlllllliIlitlllIllltitlitlItlItIttlltl State Parcel Number Legal Description
— 26-18-36-402-000.161-009 /WEST HGTS 8 _—
•
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 PART 2:TAXPAYER INFOR IATlON
First Middle Last .
IA)I. I I « a? c�crc1�
Mailing Address(number and street.city,state,and ZIP code) - ❑ Same as property address
I 03 Ben C4 *J-a.cchs / .
,.
Spouse First Middle - - Last
J -n n i no S_ Oackc�.r�cl
—Mailing AddTCSS(Nltmbeiand svttt city;suite,and ZIP code) . - ; ,: - Same as plopt.Caddies§
/08 Be,v s-�, HAC —t ,Z,J. g76 c37
.
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 liabl- -. back taxes and substantial financial penalties. -
Ownerl Sign Date
' .•c`• • PART 4: ADDITIONAL INFORMATION