HomeMy WebLinkAboutHomestead_Boehman INDIANA SALES DISCLOSURE FORM SDF ID 26-2009-1000406 IA Page
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J.ROBERT KINKLE HALL,PARTENHEIMER&KINKLE ATTORNEY
eparer of the Sales Disclosure Form Tide
N.HART ST.,PO BOX 13 HALL,PARTENHEIMER&KINKLE
Address(Number and Streell Company
PRINCETON,IN 47670 (812)386-0050
City.State,and ZIP Code Telephone Number E-mail
E SECLER(S)/GRa\TOR(S)> - - t: /- % `
ROBERT P.HORNBROOK GINGER K.HORNBROOK
Seller-Name as appears on conveyance document Seller-Name as appears on canve)• nce document
7358 N.STATE ROUTE 65 7358 N.STATE ROUTE 65
Address(:Number and Street) Address(Number and Street)
HAZLETON,IN 47640 HAZLETON, IN 47640
City.State.and ZIP Code City,Stale,and ZIP Code
(000)000-0000 (000)000-0000
Telephone Number E-mail Telephone Number E-mail
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true,correct and
complete as required by law, and is prepared in accordance with IC 6-1.1-55, "Real Property Sales Disclosure Act".
Signature of Seller Signature of Seller
Printed Name of Seller Sign Dale(Al.lf,DD'YYYY) Printed Name of Seller Sign Date(ALWDDl1T11)
FkB ' -' RA APPLICATION FORDEDUCTIONS AND CREDITS"IDENTIFY'ALL ITEl1'1SrTHATAPPLI
°PENT W. BOEHMAN
er-Mane to appears on cos - re document Buser-:Nome as appears on comrvance document
7912 ••^'- - - ••RT
Address(.\'amber and Street) Address(ranber and Street)
EVANSVILLE,IN 47715
City.State.and ZIP Code City State,and ZIP Code
(000)000-0000
Telephone Number E-mail Telephor A ,.A - E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAL • .DUCTIONS FOR THIS •ROPERTY.IDENTIFY ALL OF THOSE THAT
F L Will this property be the buyer's primary residence?Provide compl. F 3. Homestead
address of primary residence.including county: \ • _ eating/Cooling System
7358 N.STATE ROUTE 65
r5. . Power Decicec?G _66-_66_0205/_ eio3.SS( -
Address(-Number and Street)
HAZLETON,IN 47640 Gibson r 6. Hydroelectric Power Device o/ 7
City-State.and ZIP Code Cow's** r- 7.Geothennal Energy Heating/Cooling Device
r ?. Does the buyer have a homestead to be vacated for this residence?If r S. Is this property a residential rental property?
yes,provide complete address of residence vacating. including county:
E 9.Would you like to recieve tax statements for this property via
e-mail?(Provide contact information below.Please see the
instructions)br more iybrrnation.Not mailable in all counties.)
Address(Number and Street)
e /— "—e — =`II _^r 4,
City.State.and ZIP Code County ., n•OWE try ounce contact name E-mail
/r.. %LATE FORM 539.11t: TRFA511[EII POKY 75-IA
.Arrrrwto BY,TsuL:YLV,D(i NYr%L%TC__n. PLfARIBED BY TIM DEPARTY£Lt(f LOCAL GOVZILYYF1,7 FP'1\CE IC 6-I,I--_4.1
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 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 infomLalion necessary to allow county government to better monitor homestead
filings_This information will he kept conlidrntial and can only he accessed by authorized county officials.The Department of
Local Government Finance will use this information to create tolls that will brig county officials eliminate homestead fraud.
PART 1: PROPERTY INFORMATION
Taxpayer Name Property Address
Boehman, Brent W 1/
none
Evansville IN 47720
1021
Brent W Boehman
7358 N SR 68 State Parcel Number Legal Description
HAZLETON IN 47640
26-06-06-204-003356-017 Pt SE NE 6-1-9 6.44 Ac
PART 2:TAXPAYER INFORMATION j
Owner I First Middle Last
_ — e Address cnumna mnd"strect.city.state,and ZIP code]-- — _D-Same a;property-address— --- —_ __ - • —_—
nl
• S-I*L 9J (o5 -- 14e7I-Dr) II J 41(o LI n
Spouse First Middle Last
Mailing Address(Number and street,city,state,and ZIP code) ID Same as property address
Social Security Number(last 5 digits) Driver's License/State ID Number (last 5 digits) Other(plcase specify in Part 4 below)
sere
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 Signature Date
PART 4: ADDITIONAL INFORMATION
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