HomeMy WebLinkAboutHomestead_Burkhart (2) INDIANA SALES DISCLOSURE FORM SDF ID: _ C, Page 2
.D:PREPARER t-.c.a�n,ea, >t--��•�!1n._'x5^Fc4a.�i'i.a'� � ru _s�r ::r'.: .rv�+'�:'� ``. r: ' ^` � .'°
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Prepares of the Sales Disclosure Form C r Title
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Address(Number and Street) Company
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City,State,and ZIPCode Telephone Number
E-mail
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Selle'-�r(e ppears on conveyance document Seller 2-Name as appears on conveyance document
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Address(Number and Street) Address(Number and Street) g �yr-�•
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Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
and comPl< -s rfqu'red by law,audjsrpre I ared in accordance with IC 6-1.1-5.5,"Real Perty S les is ure Act".
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•.i'. -- / — Signature of Seller
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Printed Name of Seller ar Sign Date(MM/00/YIYY) Printed Name o Seller
( Sian Date(M,M/0D/YYYI')
;F;BU,Y$R(S) GRANTEES)LAPP.L'ICITION-F.ORPROPERTY,TAXDEDUGTIONS IDENTIFYAGL'ITEIjSTHAT.APP.IY „
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toyer 'arnejs appears on r• veyance document Buyer 2-Name as appears on conveyance document
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Address(Number and Street) Address(Number and Street)
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THE SALES DISCLOSURE FORM MAY RE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PRO EBTY i tu\TJ EY ALL,OF THOSE THAT APPLY.
YES NO CONDITION YES r N CONDITION
Er- ❑ 1.Will this property be the buyer's primary 19/ n 3.Homestead
residence? Provide complete address of primary ❑ d 4.Solar Energy Heating/Cooling System
residence,including county: r
Sa s e C+■t-t rso ` ❑ ❑ S.Wind Power Device
4ddress(Number and Stree[ ❑ [l 6.Hydroelectric Power Device
Ic••rti! -e_L,, -hi uc1 to-10 G 1135o, ❑ 0' 7.Geothermal Energy Heating/Cooling Device
City,State Z"P Code County
❑ I2 2. Does the buyer have a homestead in Indiana to be ❑ u $•Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 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.
c a 3 E F v.Ae YSo , Not available in all counties.)
ress(Number an�'�1 - N 11 d Sweet) .
C snr. in k-l-1.L 0 GIbSO ., R -/d-07-0?b(?4.. cop s,do -00.q
Cit State ZIP Code County
Primary property owner contact name E-mail
CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
--A STANDARD/SUPPLEMENTAL DEDUCTION FORM
L' .., State Form 5473(R13/12-09)
C.-9'-;,.;k;;--1 Prescribed by the Department of Local Government Finance
INSTRUCTIONS:See reverse side for Sing instructions.
�M C ll _ �l%� rvi7 n�y.CERLIFICATION:STATEMENT - _,-
I(We) �,[Z!1/l t�iTI.1..LS/el r - certify that I(we)o• • e.Air y(our)principal
place of residence !am(.Q)11'ng the following described real property for which a Homestead Property Taettindard Deduction is hereby claimed
under contract on the date this -.plication is filed, (date of filing). I(We): - 2013
❑ Own ❑ Am(are)buying under recorded contract n/ -
❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation pp X(bj
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualTieagrAPAIMI3 R
❑ Am (are)the shareholder, partner or member of the entity that owns the property.
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If buying on contract,Fee Simple owner's name
Recorders office where contract is recorded Record number Page
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„ n • " . s:'��- g;.,PROPERTY DESCRIPTION �• . . . . .. ,:::77.t-• _ 't,
Court I� Township Taxing district(city,at ir
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PIrcel number r�,,// �,e�� p Legal description Is the property in question:
�1 a_o )-a $oce_oaz al property ❑ Annually assessed mobile home(IC 6-1.1-7)
If any portion of the residential structure or the land not exceeding one(1)acre that immediately surrounds at structure is used to produce income,describe the use and portion
of the property utilized to produce income.
- a PROPERTY, OWNED•BY CLAIMANT IN OTHER COUNTIES -
County 1 Township County Township
I hereby certify the above statements are true,correct and complete. natu . `
Address(number and street,city,state,a •ZIP code) O
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ASSESSOR USE ONLY I TRUE TAX VALUE d AT 700°/ OFdTY I - HOVALUED I NON- VALUENTIAL
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Land not exceeding 1(one)acre immediately
surrounding residential improvements. (1)
Other land (2)
Total land(line 1 plus line 2) (3)
Dwelling (4)
Residential improvements or Annually
Assessed Mobile I Manufactured Home Garage (5) `-
Other improvements (6)
Total improvements(line 0 through line 6) (7)
Total value (line 3 plus line 7) (8)
I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,yeah
and complete.
Verifying action-Signature of Auditor Date signed(month,day,year)
_ . .
_ _ STANDARD DEDUCTION ALLOWANCE _ _ _
20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000
Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home that is $
not ass ssed as real property or to a manufactured home that is not assessed as real property may not exceed
one-h ( )of the assessed val of the mobile h e or manufactured home.
Signatu o itor �� Date sigpo(myg7 ar)