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Homestead_Hallam INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 • kI'z?PREPARER — - — � __ - -- _ Christopher C.Wischer Attorney-Lender Preparer of the Sales Disclosure Form Title 20 NW 4th St./P.O. Box 657 Bamberger, Foreman, Oswald&Hahn. LLP Address(Number and Street) - Company _Evansville, IN 47704 812-452-3595 cwischer(tbamberger.com City.State,and ZIP Code Telephone Number E-mail E;,SELL'ER[S)%GRAN;TOR(S)i_ �_ �.—_--- _�— _ _ __ _ John C C7ner Julie A C7oer Seller I-Name as appears on conveyance document Seller 2•Name as appears on conveyance document 11701 Silverlhorne Ct 11701 Silverlhorne Ct Address(Number and Street) Address(Number and Street) Evansville IN 47725 Evansville IN 47725 Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct an. complete as required by law,and is prepared in accordance with IC 6- 1-5.5,"Real Property Sales Disclosure Act". Signa .fSeller / Signatur,of Seller John C C7oer .3/?� /•7v/6 Julie A C7oer ,1/72 / Printed Name of Seller lgn Date( M/DD/YYYY) Printed Name of Seller Sian Date(MM/DD/YYYY( :PT:BUY MST/GRAN,TEE(S))=APPLICATION_FOR•PROPERTYT AXWEDUCTIONS=,'DENT IFYIALL' ITEMS'THATIAPPIN_ _ __ Anthony D. Hallam - Dana J. Hallam Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document - 1843 E. Sierra Drive _ _ _ 1843 E. Sierra Drive Address(Number and Street) Address(Number and Street) Haubstadt, IN 47639 Haubstadt, IN 47639 THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLJYAR 3 ) 201s YES r NO CONDITION YES NO CONDITION 1 U L!I ❑ 1.Will this property be the buyer's primary Qt ❑ •3.Homestead • A residence? Provide complete address of primary ❑ d�J 4.Solar Energy HeaillitgIN'00 o -: �t7z' residence,including county: ❑ L��/ 5.Wind Power Device AUD/TOR Address(Number and Street) ❑ VY 6. Hydroelectric Power Device . ❑ [v' 7.Geothermal Energy Heating/Cooling Device City State ZIP Code County ❑ 2. Does the buyer have a homestead in Indiana to be ❑ d/ 8. Is this property a residential rental property? ug vacated for this residence? If yes,provide ❑ lJ 9.Would you like to receive tax statements for this complete address of residence being vacated, property via e-mail?(Provide contact information ( incl ding c unty: below. Please see instructions for more information. ileS rP - i 247- a3 Not available in all counties.) dress(Number and Street) GI -acn COa .48,5-oaV kA -,tQa+) ►N 4•ry123q o. ;65Un Ak{-Ym 1+10_0-&In III eaalt33Ahe wile.cC City.State ZIP Code County Primary property ownd contact name - E•mall xsz- CLAIM FOR HOMESTEAD PROPERTY TAX 's 1�025'' �j 4�' STANDARD I SUPPLEMENTAL DEDUCTION FORM _ $..,, . Sate Fm S473(R15/5-14) HC10 Y.'I. Presaihed by the Deppxmnena of Loral Government Finance INSTRUCTIONS:See reverse side for tiling insbuctrns - / / / NOTE Telephone,Social Security,drivel's license,state identification and federal identification numbers are confidential under IC 6-1.1-12 ! I _ - n i • - , , ' . �.. - CERTIFICATION STATE67ENT • -. . - -- s. ?3rJ f7• ' `Z ia4CQ- I my( pa I/ x I(We) �%>• �i4 � � certify that I(we)occupied as m our��''��``��'' I place of residence or am(are)buying the following ti, 'bed real property unde`•ntract for which a Homestead Property Ta>t'9>eAd l 7 9 Deduction is hereby claimed on the date this application is signed, (date of signature). I(We): l OS.- ❑ Own. ❑ Am(are)buying under recorded contract ' ❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. G'8S),, V�j��i ❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal res.4�ne -t' A ❑ Am (are)the shareholder, partner, or member of the entity that owns the property. •Wirr- If tsyi g on conCac.Fee Simple owners name Recorders office where contract is recorded 1 Record number 1 Page Bi °. 7/7 %✓nR. ��'-3= 's' --r._ ,'c=PROPERTY,DESCRIPTION�.t`p, S''v'res co. .:/ Township -~ T1....'- f°wn.lownsliy AP/ 810 if i' - o Parcel number Lejal de/wlip]on / Is the property it ccstio.: / 4 I tel ,' • =RW property ❑Annually assessed mobile borne(IC 6-1.1-7) It any; '• of the residential raw re or the land not es....'.. ".,(.1.1.7Z" `ter sunou.is that structure is used to produce income.describe the use and portion of.if •_ tti¢ed to produs'nco me. dell soz -g3 /6 -,?6,o.-60a. gj Oa `/ PROPERTY OWNED ELSEWHERE BY CLAIMANT State. - Canty.and Townatip - Is claimant vacating a homestead? . . ❑ Yes ❑ No Sg claimant nabre of claant I hereby certify the above statements are true,correct,and complete. Address of contact(rramber and Cruet.dry,Sorb,and ZIP cede) - I Address of vacate :vd,E any(number and teat u<Y.site,end Z/Pwda) Ia- t a. A '. ASSESSOR USE ONLY I ASSESSED VALUE I HOMESTEAD VALUE' ,. VA ' it-NON-RESIDENTULL LUE Land not exceeding one(1)acre immediately — - '') -' surrounding residential Improvements (1) tr ,_ s , 1 Other land (2) -6 y �_. '4 Total land(line f plus Tine 2) (3) _ - I - _ _ Residential Improvements or Dwelling (4) Annually Assessed Mobile/ - Y Manufactured Home Garage (5) .}� Other Improvements (6) ';- a As a Total improvements(line 4 through line 6) (T) Total value (line 3 pits line 1) (6) I hereby certify the above is true,correct, Signature of Assessor Dore signed(month,day,year) and complete. Vadyiy action-Signature ofAUdtor Data signed(month.day.year) °°e -isrnr DARU DEDUCnon'Ai:MANCE . 20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000 Notwfth•anding any other provision,the sum of the deductions provided Li IC 6-1.1-12 to a mobile home $ that is not assessed as mai property or toe manufactured home that is not assessed as real property may not exceed one-half(112)41/the assessed value of the mobile home or manufactured home. Signature of Author Data signed(math,day,year) DisTRlaunoN: Drigb-al-Casty A:rddr,Fie Stamped Copy-Taxpayer