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Homestead_Stillwell INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER • DAN L. REEVES ATTORNEY Preparer of the Sales Disclosure Form Title 116 S. MAIN ST. REEVES&COCHREN Address(Number and Street) Company PRINCETON. IN 47670 812/385-8641 City,State,and ZIP Code Telephone Number E-mail E.SELLER(S)/GRANTOR(S) - • - HUBERT R LOVFLESS JR JUDITH A LOVELSSS Seller I'Name as appears on conveyance document Seller 2-Name as appears on conveyance document 769 S SR57 769 S SR57 Address(Number and Street) Address(Number and Street) OAKLAND CITY IN 47660 OAKLAND CITY IN 47660 Under •enalties of perjury,I hereby certify that this Sales Disclos • to the best of my knowledge and belief,is true,correct and c. p •to as rent]. ed b�:w,and is prepare• in accordance WI. 6-1.1-5.5,"Real Pry erty Sales Disci.sure Act" AI Signature Se, -r Signatu •of Seller /13'26" 0.26./9- Printed Name of Seller Sian Date(MM/DD/YYY1i Printed Name of Seller Sion Date(MM/DD/YYYJY F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY AL ft 1 TrA,70(PPLITN IIEFFREY SCOTT STILWELL ) 1p1p I��--y 3 ry ( Buyeri-Tamru>..,,x.,,o,,.,,nalmue toocument Buyer 2-Name as appears on conveyance document 319 S SR57 AUG 26(Number and Street) Address(Number and Street) O 2014 OAKLAND CITY. IN 47660 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 • • • II IN 0 ,p 1.Will this property be the buyer's primary I 0 ❑ 3.Hornestead residence? Provide complete address of primary '- oar nergy Heating/Cooling System residence,including county: 319 S SR57 ❑ 5.Wind Power Device Address(Number and Street) ❑ SI 6.Hydroelectric Power Device OAKLAND CITY, IN 47660 GIBSON State ZIP Code County 0 7.Geothermal Energy Heating/Cooling Device City, ❑ C 2.Does the buyer have a homestead in Indiana to be ❑ 8.Is this property a residential rental property? vacated for this residence? If yes,provide ❑ Fl 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. • . . .. - . Address(Number and Street) City,State ZIP Code Co my .-ake CLAIM FOR HOMESTEAD PROPERTY TAX YEAR STANDARD/SUPPLEMENTAL DEDUCTION State Form 5471(Rt515-14) HC10 Presented byte Department of Local Government Finance FORM INSTRUCTIONS:See reverse side for frig instructions NOTE:Telephone,Social Security,drivers license,state identification and federal identification numbers are confidential under IC 6-1.1-12-(. jr6 171— %°Y��''-" . CER'1FICATIOONN ST�ATEMMEENT" ` . -'J.Pt17. ':3-= I(We•-�t1_//7��If/1f 7�/L�I�J certify that I(we)occupied as my(o •••n ,f pal pia si.er ff r a - -)buying the following described real property under contract for which a Homestead Property Tax Sta •=-. ,' •-• is h-reby d- on the date this application is signed, (date of signature). ' ❑ Am(are)buying under recorded contract 1),' ❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. /� p ❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualifieQ( 434 .-ncce trust ❑ Am(are)the shareholder, partner, or member of the entity that owns the property. 8N CO _, i " —- if buying on contact,Fee Simple tenets name Readers o5ce where=Kidd is recorded • Record number 1 Page T ,gj $?�•�w'llat,';��i�rle -PROFigil ESCRIP-TICK"d - K ! + �^ 'u s..� $ Toenshiy Taxing..,sw orgp. � '� i AAP 1 P--camber F-•-.-m/ Is-the • dY In RUesYri �y 7 - )--a? I Real popery ❑Mnuaty assessed mobile home(IC 61.1-7) t any portion of the resifer'..ial=Iran or the land not Gex ee6Sp—gore(�1—)�aaos OF`• . ...•.,-that stnyare a used to produce bore e,describe the use and pod= of the property utilized to income. ( i . ��-/ 2 . Ce-C/a a- Ada-Q.G -:PROPERTY OWNED ELSEWHERE BY CLAIMANT _ . - _ State,Carey,and Township Is claimant vacating a homestead? . - ❑ Yes ❑ No - I yona' airn= f I hereby certify the above statements are true,correct,and complete. y( a 7_ i72 5 4//7�',2J�,/� d Address of co tact(number and sheer.cry,state,end LP code) rl Andress of vacated homes laid,i any(number and street,try,gate, 'end LP code) 14 , St41e2e2c.01 5/I o a.!,k.Nrr//erfrt- //lid o �- ASSESSOR USE ONLY •I t ASSESSED VALUE -• I HOMESTEAD VALUE` ;I- .`NON ESISIUENTIAL-.: Land not exceeding one(1)acre Immediately (1) a ` e i surrounding residential improvement _ - __ _ Other land (2) v"`..... T_'. ITotal land(line 1 plus line 2) (3) _ _ _ _ Residential improvements or Dwelling (4) Annually Assessed Mobile l Manufactured Home - :n±as .' Garage (5) k.. _ - Y-�_ _ __._< Other improvement (6) ,. ._ . --- +... -i-.. Total improvements(fine 4 through line 6) (7) Total value (line 3 pits line 7) I(8) I hereby certify the above is true,correct, I S'grnrture of Assessor Data signed(`snug day,yea') and complete. Verdyeg aeon-Signature of Auditor Date signed(month,day,yea) ids- 35TANDARODEDUGT1ON'ALLOWANC -•'-'- -- ':_ +kr.t 20 pay 20 Lesser of 60%of the assessed value of the homestead or 545,000 Notwithstanding any other provigon,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $ that is not assessed as real property or to a manufactured home that is not assessed as real property may not exceed one-hall(12)of the assessed value of the mobile home or manufactured home. 6'gnat=of Audio/ Data Signed(nn-M.day,Year) DISTRIBUTION:Original-County/U-1Zr,FtleSanged Copy-Taxpayer