Homestead_Motter INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 3 '^ 7t -act. q. t--; f4 s 'n rs:t W ,7 t'+ c.T -s a--- Q s i tea: rD PREPARER:t'-_.zr�,»-�cer.�i��a '#�s% +:...r�.... . i~s�.. ..,�s.., -_th a � x.. i ", .���%'� .. J. Robert Kinkle Attorney Preparer of the Sales Disclosure Form Title 219 N. Hart Street, PO Box 13 Hall, Partenheimer& Kinkle Address(Number and Street) Company Princeton, IN 47670 812-386-0050 irkinkle(1a hok-law.com City,State,and ZIP Code Telephone Number E-mail :E SELLER(SjfGRANrIFOR(S)- f.-�s ii-VI: '4Y"R 3•'i- x al t Wa .—Ri 7 a Y' Gary D Starnes Jr I ova A Stamen Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 144 Brandywine Drive 144 Brandywine Drive Address(Number and Street) Address(Number and Street) Belden, Mississippi 38826 Belden, Mississippi 38826 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 I 6-1.1-5.5,"Real Property Sales Disclosure Act'. ��%�� r Signature of r ignature of Seller Gary f) Starnes Jr /5 �^ n y J CSR A. Starnes /o/vi jicz Printed NamefSeller ign Do (MM/DD/YYYY) Printed Nome of Seller gn Date(MM/DD/YfY) PTIE III( /GRANTEE(S) AERIAGATIOWFOR?P:ROP,ER•TLY TAX+DEDUCTIONS=IDEN.TIF llfilTEM AiFA PLY.,Br--�,�y7r,( ('Ri -rd A. Mott- • i - L. Motter N , t 1 .. . - •ame as appears on conveyance document Buyer 2-Name as appears on conveyance document — 5356 S 950 W 5356 S 950 W c C f o 0 2014 Address(Number and Street) Address(Number and Street) Owensville, IN 47665 Owensville, IN 47665 THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION NO CONDITIO 0 ❑ 1.Will this property be the buyer's primary [f ❑ 3. Homestead residence? Provide complete address of primary ❑ ❑ 4.Solar-Energy Heating/Cooling System residence,including county: 5-3fl S Y 3o tA) ❑ ig 5.Wind Power Device ^Address(Number na Street)._N 4 6 ` �( !BS�� ❑ ❑ 6. Hydroelectric Power Device I.a QNStit is 4 J 0 ❑ 0 7.Geothermal Energy Heating/Cooling Device City,State ZIP e County ❑ 2-Does the buyer have a homestead in Indiana to be ❑ � Is this property a residential rental property? vacated for this residence? If yes,provide ❑ L1K 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) 026 - / 7 -03 - 3o0 - 00/, 1 X 3 - o d / City,State ZIP Code County — Primary property owner contact name E-mail STATE FallA 535A(H:/lYI) TREASURER FORM TS-IA APPROVED BY STATE BOARD OF ACCOUNTS.2009 FBEflSED BY THE DEPARTMENT OF IDEAL GOVERNMENT FTYAM£IC 61.1325.1 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 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 indentifying 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. PART 1: PROPERTY INFORMATION Property Address(number and street,city,state,and ZIP c ) x"3 .5-6 S 9:50 aveAo 2.///e , & a. State Parcel Number - aZ— / D3 -Ow- to/ /43 -001- / FILED APR 162014 PART 2:TAXPAYER INFORMATION UDITOR Owner 1 First Middle Last . ids w2s4 Mailing Address(number and street,city,state,and ZIP code) El Same as property address 5 35' S 2'2 Spouse / /� First Middle �a(4° Last Mailing Address(Number and street,city,state,and ZIP code) ID Sanpc/as property address 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. Own r Signature Date PART 4: ADDITIONAL INFORMATION 'A/ .� / - i ; INSTRUCTIONS • i