Homestead_Hardiman STATE FORM 53369(Bit-09) TREASURER FORM TS-IAI
Aa.`OYED.TrY STATE(WARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOVAI GOVERNMENT FINANCE ICbl.l22-8.1
4
IMPORTANT,NOTICE TO HOMESTEAD PROPERTY OWNERS
Individuals and married couples are limited to one homestead standard deduction. As the receipt of this
dr`'uction becomes more beneficial, there is more incentive than ever for homestead fraud. Homestead fraud
uses higher tax bills for all; therefore, HEA 1344-2099 requires taxpayers who receive the homestead
st. ndard deduction to verify that they are eligible to receive the 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 Department of Local
Government Finance will use this information to create tools that will help county officials eliminate
homestead fraud.
PA' 1: PROPER Y ,'FORMA ION .
iaspaver Name Property Address State Parcel Number Legal Description:
Mark C Hardiman ns Lot 3 pt 42 26-12-07-200-004.253-028 019-04253-00 New Survey Lot 3 Pt
R2
Complete and return to: A
GIBSON COUNTY AUDITOR, 101 N MALN PRINCETON IN 47670
• PART 2: TAXPAYER INFORMATION
Owner 1 Fast Middle Last
inAR k c a US N) A/4i ( .02---pi,q,..)
Meiling Address(number and street.city,state and ZIP code) r
Pr (�ne as property address
.4"na F. ,QI<- // Et; C1 ,ID 1'ri iJGL—I rJ I— a.1 V74)7a J ?. 2—
)
S, ,se First Middle Last
Mating Address(number and street.dry.state and ZIP code) Sane as property address
Social Security Number(last 5 digits) diver's License Stale ID Nunter(last 5 dIgib) State Other(please specify in Part 4 below)
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 1 Signature �[/ Date
)
PART 4:ADDITIONAL INFORMATION
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INDIANA.SALES DISCLOSURE FORM SDF ID 97-2013-8825692 Page 2
D:PREPARER- a, a; =
Shamus McFerson Netco Title
Preparer of the Sales Disclosure Form Tide
377 Crown Industrial Ct. Netco Title
Address(Number and Street) Company
Chesterfield,AL 63005 (877)776-3826
City,State,and ZIP Code Telephone Number E-mail
Mark C Hardiman
Seller-Name as appears on conveyance document Seller-Name as appears on conveyance document
502 East Brumfield Avenue
Address(Number and Street) Address(Number and Street)
Princeton,IN 47670
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 6-1.1-5.5,"Real Property Sales Disclosure Act".
\5(gnatture of Seller `igna tore of Seller
014/2./c 6 . /7t42,_mm,J Si /d -/3 /,
Printed Name of Seller Sign Date(141/DD/1111) Primed Name of Seller S,qn Date(MM/OD/MY)
F:BUYER(SVGRANTEE(S)--APPLICATION.FOR,DEDUCTIONS AND CREDITS,ADENTIFY-ALL ITEMS THATAPPLY• .
- DULY EN'T FOR TAICAT{OH` ---
Mark C Hardiman Tina M Hardiman �,r(gr
Buyer-,fame as appears on conveyance document Borer-Name as appears on ro�u��ft1�.{�1 3�eP
tanca{or tro
502 East Brumfield Avenue 502 East Brumfield Avenu �{
Adds ess(Number and Street) Address(Number and Street)J
Princeton,IN 47670 Princeton,IN 47670 Auditor
Telephone Number Pala,, E-mail Tax lidl(Y/N)
II'IIE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY.IDENTIFY ALL OF THOS'
F. I.Will this property be the buyer's primary residence?Provide F 3.Homestead
complete address of primary residence,including county: (— 4.Solar Energy Heating/Co ing t
502 East Brumfield Ave
F 5.Wind Power Device [ 1.2:2013
Address(Number and Street) SE p
Princeton,IN 47670 0 r 6.Hydroelectric Power Device
City,State,and ZIP Code Comity r 7-Geothermal Energy Heating/Coo Devi. lei
�I•!
r 2.Does the buyer have a homestead to be vacated for this residence? r B.Is this property a residential re ill @,'cosITY AUDITOR
If yes,provide complete address of residence vacating,including GIBSB
county: f- 9.Would you like to recieve tax statements for this property
via e-mail?(Provide contact information below.Please see the
instructions for more in)armation.Not available in all counties.)
Address(Number and Street)
2[ — - igym en__ e?53 - oa8
City,State.and ZIPCode County Primary property owner cantor:nine E-mail