HomeMy WebLinkAboutHomestead_Dewig (8) •INDIANA SALES DISCLOSURE FORM SDF ID: i Page 2
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Karen Harbison VP
Prepare of the Sales Disclosure Form Title
0 803 E State Rd 68 Elberfeld State Bank
Address(Number and Street) Company
Haubstadt IN 47639 812-768-5800 kharbison{a�esbanc.com
Ciry,State,and ZIP Code Telephone Number E-mail
gE SECCER(Sr/GRANTOR(S) -- 'a-- .: - — _= i =; E: __. -':t
Dean A Dewig Karen A Gilles
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
204 N Race St 704 N Race St
Address(Number and Street) Address(Number and Street)
Haubstadt IN 47639 Haubstadt IN 47639
Under p- • : ties of perju hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and/• p •to as req • ed . .w,and is prepared in accordance\with 1 -1.1.5.5,"RRa{Property Sales Disclosure Act".
' �iA'/ • / o�, ((K� rby �� ate,„
/ ;nature of Seller Sign cur of Seller
Dean A Dewig 09/11/2012 Karen A Gilles 09/11/2012
Printed Name ofSeller Sian Date(MM/Da/YYM Printed Name ofSeller Sign Date(MM/DD/YYYn
MR(S) RANTEE(S);<AP.P•GCATIONiFORiliROPERTYTA]{aDEDUC T. IFYiAIiLITEb1S4THATAPPL-Y73!:s -C``i-11
Dean A De 9 Karen A Dewiq
.ame as appears on conveyance document Buyer appears on conveyance document
204 N Race St 204 N Race St
Address(Number and Street) Address(Number and Street)
Haubstadt IN 47639 Haubstadt IN 47639
®
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. ii • a• I F THOSE THAT APPLY.
YES NO CONDITION I NO CONDITION
0 ❑ 1.Will this property be the buyer's primary Q ❑ 3.Homestead
residence? Provide complete address of primary • n - ergy Heating/Cooling System
residence,including county: ❑
204 N Race St 5.Wind Power Device
Address(Number and Street) ❑ Q 6.Hydroelectric Power Device
Haubstadt, IN 47639 Gibson' ❑ 0 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ 0 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 ❑ 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.)
•
Address(Number and Street)
City,State umber a
0,76-/9-..1/-d o/- �•��-009
County
Primary property owner contact name E-mail
SIAM FORM 5351.1P2/fail 17.FASUROl IOLM iSIA
.1erR(T'ED BY MAIL BrAPD Or Arrlt\'r'.2N PRr-YAIBEDnY rnr DEPARTMENT OE LOCAL tOVER.V t•IFINA' terl.l-c-r.l
Gibson County Auditor
101 N Main
IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS
PRINCETON IN 47670 Individuals and married couples are limited to one homestead standard deduction.As the receipt of this deduction becomes
more beneficial.there is more incentive than ever for homestead fmud.Ilomestead 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 recene the
benefit and to provide additional identifying information necessary to allow county government to better monitor homestead
filings.'this information will be kepi confidential and ran only he accessed by authorized county officials.The IRpanntent of
Local Government Finance will use this information to create totals that will help county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Dewig, Dean A/Karen A Gilles
PO Box IS
Haubstadt IN 47639
•
8185
Dean A/Karen A Gilles Dewig
P O Box 147 State Parcel Number Legal Description
Haubstadt IN 47639-0147
IrI1rILrrLlLrrrllilJrJI ILIrrILtrLI.•IIuttllrrIiI 26-19-31-301-000.542-009 PT3-00542-00 ORIGINAL PLAN 45/46/47
-{
PART 2: TAXPAYER INFORMATION
Owner I 52., First Middle Last
an
•
c an ` `"
• tg Address(number and snort,city,state,and ZIP code) 0 Same as property address
clJ' N. `-iac2 cal . . +IUk.)._bs a 5
Spouse First Middle Last
•
jCtren gnY1 eu"fi
Mailing Address(Number and street,city,stale,and ZIP code) .}71 Same as property address C2 l
90`4 Ni . Race S • 1 -1-)o ut b5-4a d-1- ,-7 W 11-1--) c�.�9i i �11-ti
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 fo • ck taxes and substantial financial penalties.
Owner (gnat Date
- - _
•
PART 4:ADDITIONAL INFORMATION
•
CLAIM FOR HOMESTEAD PROPERTY TAX
}'= CREDIT /STANDARD DEDUCTION
State Form 5473 (R2 / 5 -92)
psis
INSTRUCTIONS: See reverse side for tiling instructions.
as our principal place of residence the
G (We) owned ❑ Are buying under contract
❑ Have a beneficial interest in the entity that is liable for the
FORM /YEAR
HC10 V7
cerQ{ltithohe 1�i-laylbf f,�rch, 191
aed real property for which a Homeste Pro 7�x jit reby claimed:
MR 31 1994
taxes on the property and that owns the property or is buying under a contract.
CONTRACT RECORDED AU
it Vn- -
It buying on contract. Fee Simple owner's name
contract
Record number I Page
PROPERTY DESCRIPTION
County
Township
Taxing district (ci o to Of
P I
e_ OJ ^
Leg al description
It any portion of the residential structure or the land not exceeding one (1) acre that immediately surrounds that mcture is ad to pr6dluce income, describe the use and portion
of the property utilized to produce income.
I PROPERTY OWNED BY CLAIMANT IN OTHER COUNTIES I
IW-reby certify the above statements are true, correct and complete. ✓ I Signator I d ant
Address (number and street. city, state, ZIP code)
20'21 1?f10ES7 / ?lL14PfZgL
- ASSESSOR USE ONLY
TRUE TAX
VALUE
ASSESSED
VALUE
HOMESTEAD
VALUE
NON- RESIDENTIAL
VALUE
Land not exceeding 1 (one) acre immediately
surrounding residential improvements. -
(1)
-
Otherfand
(2)
Total land (line 1 plus line 2)
(3)
Residential improvements
Dwelling
(4)
-
Garage
(5)
Other improvements
(6)
Total improvements (line 4 through line 6)
(7)
Total value (line 3 plis line 7)
(6)
1 hereby certify the above is true, correct, and
complete.
Signature of Assessor
Date signed
vying action - Signature of Auditor
Date signed
19_Pay 19_
Lesser of 1/2 Homestead
Valuation or $2,000
Signature of Auditor
STANDARD
9