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HomeMy WebLinkAboutHomestead_BucklerC r L INDIANA SALES DISCLOSURE. FORNI SDF ID SDO U) 725978 Paget D.PREPARER Kimbell A. Lewis Office Manager Pieparer of the Soles Diulasure form Title 226 W. Broadway Broadway Title, Inc. Addrm (Number and Street) Caroway Princeton, IN 47670- E. SELLERS GRANTORS Beth E. (Robbins) Mincey Sellerl - Name ar appearson mnvesrmce document SrNerd Notneasoprarsenrocuevuraoducarotm 374 S. Strawberry Hall Rd. Address (Number and StreeO Addrrss(h'umberand Streer) Wheatland, IN 47597 - 0a vState, and ZIProde Cary, Stale,and2,IPCade , I E -mull TeloPh.ce Number E -mail Under penalties of perjury, 1 hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and co%plete as require y law, and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". /��, f �Z ��J//j� , S, amr ofsell" Signamreofscller n All F /`o ;fns / ?C/ F. BUYERS ES - PLICATION FOR OPERTYTAXDEDUCTIONS- IDENTIFYALLITEMSTHATAPPLY Christ o r J. Buckler Ami Jo Buckler e eel Nomem o^ mm�veyvnte docvmen: Buye r? - Name asnppears on convevence document 000 W. Broadway 1000 W. Broad,may Addrm (Number and Sueet) Addrm (Number and Street) Princeton, IN 47670- Princeton, IN 47670 - City. State. and ZIP Code Cary, .Store, and ZIP Code (,) � ' Telephone Number E -mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN UEDULTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YES NO CONDITION x❑ ❑ 1. Will this property be the buyer's primary ❑X ❑ 3. Homestead residence? Provide complete address of primary ❑ © 4. Solar Energy Heating /Cooling System residence, including county: ❑ © 5. Wind Power Device 620 S. MOHICAN DR. ❑ ❑ 6. Hydroelectric Power Device Address (Number and Street) Patoka, IN 47666 GIBSON ❑ © 7_ Geothermal Energy Heating /Cooling Device ❑ © B. Is this property a residential rental property? Ciy State ZIP Cade County ❑ 2. Does the buyer have a homestead in Indiana to be 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. Notavailable in all counties.) Addrm(NUmberaad SVeet) .] Q� �b - ON - Q 5 e Wo 000 5 D5 - o.1c. Cary, State ZIPCode County . 1'rimaryproperry owner contact name 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 required by law, and is prepared in accordance with IC 6- 1.1 -5.5, "Real Property Sales Disclosure Act ". (Note: Spouse information, Social Security and Driver's License /Other numbers are not necessary if no Homestead Deduction is tied.) y r/. l'.J-^r_ =jjignatareofByerl Signatureal' er1 /Spouse l� }�rls�hae" S, �.wc -�Izr ll �04 -2011 �j,,, -) V�t.K- I_k.�L �� IV}IZCII Printed Legal Name ofauyer l S(gn Dow(MmIDDIM11 Printed Legal N2ameafavy-er 215aouse Sign Dow(N.4/DU/M71 Nk ( of Social Security Number Lost 5 digits of Buyer 2 /Spouse Driver's State Last 5 Digits of5ocicl Security License /ID /Other Number Number License /ID /other Number STATE FORM 53569(R15-10) TREASURER FORM TS-IA APPROVED BY STATE BOARD OF ACCOUNTS,2009 PRESCRIBED BY THE DEPARTMENT OF LOCAL GOVERNMENT FINANCE IC6-1-I-22-6.1 - 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 It uses 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. PART1: PROPER Y INFORMA ION Taxpayer Name Property Address State Parcel Number Legal Description: Christopher.1 Buckler 620 S MOHICAN DR 26-04-25-100-000585-020 PT SE 25 1 1 1 1.463 AC PATOKA IN 47666 Complete and return to: I®IIDDImmOJfI I ME RI IthaR�©mOJmO GIBSON COUNTY AUDITOR, 101 N MAIN PRINCETON IN 47670 IL9W Ill PART 2:TAXPAYER INFORMATION " Owner I First Middle Last CheIS}ophQC* J o,,rfle.S ucK1 er Mailing Address(number and street.city.slate and ZIP code) I I%Same as property address (CI S. (Thhlcar 172, I.Pc,blt3TN <-I7(o4,b First Middle Last A nn `10 Buckl.e.r Maittng Address(number and street,city,state and ZIP code) 1C1 Same as property address � ) S. (rlohtco.r.Da, , III t �ufvkL. c l� 1-17(0(0 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 ba . - es and substantial financial penalties. • er S/9 re Date . , PART 4:ADDITIONAL INFORMATION,. _ . • FIB . • • NOV 1 422012 GIBSON COUNTY AUDITOR