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Home My WebLink AboutHomestead_SmithINDIANA SALES DISCLOSURE FORM SDF ID: r - �PaRp v 9 /11 Ray M. Druley Attorney No. 4759 -26 Preparerafthe Soles Disrlosure Form nde 505 N. Church St., P.O. Box 146 Law Office of Ray M. Druley Address (Number and Street) Company Fort Branch, IN 47648 £ -moll [^ l Sd/er1 Nar��appro nron cdY1eO -3 /_ Seller 2 -Name as appears on ronveyance dxumen1 once he b 2- �p �(! Addrcss(Num ran Street) �,� % 2h - TN �t76 f f D WI Address (Number and Street) to City, State. and ZIP Code bry, Stott and ZIPCade Telephone Number E -mall Te /r hone 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 r qulred bylaw, and is prepared In accordance 4 -_�� with IC 6- 1..1.5.5, "Real Property Sales sclosure Ac['. Sfgnatur /SrLrr -M4 (1-' 0(4.PAOh f -)00Lf Srgnamre oJSeller i o`Is .T, 91-u j'61, C -I -2004 Printed . NamelFler G Sign Date . MM DD a{F# 011 0RW- TT ,/ 11DiCRED.UTiS Printed Name O Seller Sign Data MM /DD 1 t- Buyer 1 - Name as appears on ronveyance document Buyer 2 - Name as apprors on conveyance document X02 ah, o -302 �i4, �a Addrea(Numberany xia� d -ode Sorel) bt Tl� `(76 �f Address (Number and5trcet) V 76 0 Af it2 I P 'f In iry, Smlq and ZlP Code Ciry, S ale, and ZIPCod< Telephone Number E -mail Telephone Number E -mall THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YES NO CONDITION ❑ 1. Will this property be the buyer's primary [Ly ❑ 3. Homestead residence? Provide complete address of primary ❑ EV 4. Solar Energy Heating /Coaling System residence, including county: r � �,• � � 'I te? ❑ Q,,'S. Wind Power Device ❑ Lh 6. Hydroelectric Power Device ❑ Z 7. Geothermal Energy Heating /Cooling Device Address (Number and Sore t) ,a -z— �6 city,Smle ZIP a County ❑ Does the buyer have a homestead to be vacated for ❑ 8. Is this property a residential rental property? this residence? If yes, provide complete address of residence vacating, including county: �� -oa- �9- X33 - �Q�• o �� " G �� Address (NumberandSveel) Cry, ZIP Cade County Under penalties of perjury, l 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'. Signature ofBuyerl f I 'Y �;�rn6( -A L, 5M'ItV1 (9 - I'1U0 Signature ofBuyerl L0;5 �, 61av,-IDI� -I'2oo�f Printed Name lhne,l sic. Date MM/DD Printed Na... fBove,2 Sign Date MM /DD 9 /11 STATE FORM snag(RI/B-10) TRE.SL'mR FOLK TS-IA APPROVED BY STATE BOARD OF ACCOUVtS,2009 PRESCRIBED BY THE DEPART4EST OF LO CAL GOVERNMENT FINANCE IC 6-1.1IId1 . Gibson County Auditor • C IMPORTANT NOTICE TO HOMESTEAD PROPERTY OWNERS 101 N. Main Street Individuals and marred couples are limited to one homestead standard deduction. As the receipt of this deduction becomes , Princeton,IN 47670 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 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. PART 1: PROPERTY INFORMATION Taxpayer Name Location Address Smith, Richard R/Julie Stice 209 S Ohio Hazleton IN 47640 265 Richard R Smith I0I III IIII1111IIIIII1II-fIIlIIII-Ii1IIIDII_IhIII[1IIIIII I IIIllII ftI1III 209 S Ohio St' HAZLETON IN 47640-8902 ll'I"I"11"ll11"'11111"'IFI1tllll1'I1III1'll'I�Illllttltllitl State Parcel Number Legal Description 26-02-59-033-000.018-01 ENLG 122 FILED y APR 6 2011 This far ,,akturned to County Auditor's office. Please do NOT send this form back with your tax payment to the county treasurer. t1I 0A11 •1 It;a A`Ixy]ME%IfII - - — - Ov. . 1 First Middle Last o yak $ *2 Mailing Address(number and street,city,state,and ZIP code) Same as property address zo9 o /4io S fr S. lone /e *oev ZPJ . 4'2 VO Spouse First Middle last ffr, l e c.e 14Nu) 4-; C, �. • Mailing Address(Number and street,city,state,and ZIP code) Er Same as property address 2, 09 DHio /fFiz Le +e =r-) , V2‘yo 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.