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Homestead_Wilkinson INDIANA SALES DISCLOSURE FORM" SDF ID: Page 2 D.:PREPARER _,- • - .. ,. a= 7_. ac:i SHANNON LIBBERT MGR Preparer of the Sales Disclosure Form Title •703 THEATER DRIVE REGIONAL LAND Address(Number and Street) Company EVANSVILLE IN 47715 812-402-4553 NA Ciry,State,and ZIP Code Telephone Number E-mail E.SELLERS)/GRANTOR(S) ._ _ -. - - ..-- W ._ H MARK IUNGHUHN TFRRY I II INGHUHN Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document // .3�4- o a /tJ /j3,Q E 20 C ti/ Addy Number and 5tr t) Address(Number 9nd Street) re-,A •"7<e Vii �/7( 7C/ ` r-i/1 CP;Thh1 . [/l) tf7tTO Under penalties o perjury,I h) .y certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct .anitcomple e as re•uired . 'aw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property ales Disclosure Act". Signature of Seller Signature a eller ,ti:• k • :. r TERRYIIUNGHUHN 9— /5—// • Printed Name of Seller S'.n Date(M I/DD/YY19') Printed Name of Seller Sian Date(MM/DD/YYYY) :F.:BUYER(S)/GRANTEE(S)-=AP.PLICATION`FOR PROPERTY,TAX DEDUCTIONS-IDENTIFY ALL:ITEMS THAT:APPLY- PRISCILLA A WILKINSON �� °rI-Name as ppears an(fonveyagce_ ocument Buyer 2-Name as appears on conveyance document `)'(N sc? I0. A till 11—P MSo�1 Agdress(Number and Street) / Address(Number and Street) ® THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION I YES NO CONDITION is ❑ 1.Will this property be the buyer's primary 12 ❑ 3.Homestead residence? Provide complete address of primary ❑ N 4.Solar Energy Heating/Cooling System residence,including coun LiU,- co s 4�n Nn k 4s° ❑ 0 S.Wind Power Device �.address(Number and Street) /Gut r ❑ 0 6.Hydroelectric Power Device NZA,Y\(J.i r n IN) ��4"1 . \` , so ❑ 12 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County ❑ �J 2.Does the buyer have a homestead in Indiana to be ❑ 0 8. Is this property a residential rental property? vacated for this residence? If yes,provide ❑ N 9.Would you like to receive tax statements for this Ja complete address of residence being vacated, property via e-mail?(Provide contact information including county: below.Please see instructions for more information. N // r— Not available in all counties.) - Address(Number and Street) a to—o(c—f.300.00 3. &q5 l PRISCILLA A WILKINSON City,State ZIP Code County Primary property owner contact name E-mail STATE FORM 53569(RJIB-10) TREASURER FORM TS-IA APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE ICS-LI"-8.1 IMPORTANT NOTICE TO;-HOMESTEAD PROPERTY OWNERS 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 uses higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead s Idard 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. PARTI: PROPERTY INFORMATION. Ta cer Name Property Address State Parcel Number Lena!Description: Priscilla Wilkinson 6766 E 450 N 26-06-17-300-003.645-017 PT SW 17-1-9.602 AC FRANCISCO IN 47649 C-I Complete and return to: I®IIODJ h mL11lnmll© 0'B®1111 MIIIIMEMI® GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 UI / • . PART 2:TAXPAYER LN FORW ATION y/ n, Owner 1 i SCi I! d First / / n� r) / lHddle � //1 /`'l'JDrt Last Mailing Address(number and street city,slate and ZIP code) �/1� 1 Same as property address First Middle Last Matting Address(number and street.city•slate and ZIP code) Same as property address creed Security Hunter(last 5 digits) envois License/State ID Number(last 5 digits) Sue Other(please specify in Pan 4 below) PART 3: CERTIFICATION l 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 I Signature Date ( ) PART 4:ADDITIONAL L\FORMATION FILED • NOV 9 12012 GIBSON COUNTY AUDITOR