Homestead_Scott Jr - `CLAIM FOR HOMESTEAD PROPERTY TAX- , `YEAR
`;N ; STANDARD I SUPPLEMENTAL DEDUCTION FORM
Stata Form 503(R15/5-14) HMO
Prescribed by tie Department of Local Gown-rent Finance
INSTRUCTIONS:See reverse side for filing instructions.
NOTE:Telephone,Social Security,&Nets license,
- - _1 certify that I(we)occupied as my(our)principal
place of rs fidence or-if(are)buying the following•escribed real property und-r••ntract for which a Homestead Prot jT $1rgar!C
Deduction is hereby claimed on the date this application is signed, (date of sgnaA*'jRI(be) LU IU
❑ Own. ❑ Am(are)buying under recorded contract
❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. I _I ei
❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified ppeerso i i�Yi1De
❑ Am (are)the shareholder, partner, or member of the entity that owns the property. ' IBSON COUNTY AUDITOR
If buying on contract Fee Simple owner's name -
Recorder's olce where contract is recorded - I Record number 1 Page
-rkt -7.2 _' ._r >..*Oi ^cjPROP,ERTYrDESCRIPTION, .ji t 2;11-4i S=-.�_•..3+5 4=./
Cagy Township 1 Taa±g-b�Tt�(ciittty,Wan l-o'xnshy) i
Pars)r.rnbe Legal description /A ,Y.3$ A c`�(///Is the prom in condom
PT 5 t 5[l] as /-I/ ❑Real property- ❑ Annviy assessed mobae hone(IC 6-1.1-7)
If any portion of the resideraal s-xaae or the land not exceedrg one(1)acre that itit ta:ely=rounds that sncbse is used to produce income,desebe the use and portion
of the property elided to produce eoase.
a (o ,o4- c25 - 30o - oo5 . 597 - o}- o
�.- � ,•; ._ " 'PROPERTY OWNED ELSEWHERE BYCEAIMANT _ 't _ •
Spa.County,and Township Is daimanivacating a homestead?
' ' ❑ Yes ❑ No
Signature o mar' / L'�
I hereby certify the above statements are true,correct and wmplete.k-
Address of ooaaci(number and street say,slate,and ZIP aiden)) I Ad of ed homestead,if any(nu and greet et t gate,and ZIP code)
.kj ? 3fi' rig/e .Crtsti A.•. 04a CIA/474(4
ASSESSOR USE ONLY . I ,ASSESSEDVALUE •IJ'•.HOMESTEADVALUEc,II .- -NON-RESIDENTIAL • •
VALUE:"
Land not exceeding one(1)acre immediately --:•t.
surrounding residential Improvements (t) G.•e''
Other land • (2) � '
Total land(grief plus line 2)_ (3) - . - - _ . _ — _
Residential Improvements or Dwelling (4) r `7 a-_-t~-
i`, ...Y:
Annually Assessed MObile I
Manufactured Home Garage (5) • '�pj.,3+-y�s_+`Y'-: "k 'e1-
Other Improvements _ (6) '�°� c ,;u3'�'
Total irtiprovemente(line 4 through line 6) (7)
Total value (line 3 pies line 7) (a)
I hereby certify the above is true,correct, Sy-nature of Assessor Date signed(n.an(h,Coy,year)
and complete.
Vet:nig aeon-Sgrature of Andtsr Date signed(north.day.year)
"? - "='Oft =-t"= STANDARD DEDUCTIONALLOWANCE 5-. - -. -Yi'4 _
20 pay 20 Lneaer of 60%of the assessed value of the homestead or$45,000
Notwithstanding any other provision,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-half(1R)of the assessed value of the mobile home or manufactured home.
Signature of Aud o, Date signed growth(ley,year)
< TION: /,1,-(--
DISTRIBUOrigral-county Auddon,Fie-Stamped Copy-Taxpayer
_.INDIANA SALES DISCLOSURE FORM SDF ID: Pam
D.PREPARER
J. Robert Kinkle Attorney
Preparer of the Sales Disclosure Form Title
219 N. Hart Street Partenheimer, Kinkle& Ricker
Address(Number and Street) Company
Princeton, IN 47670 812-386-0050 irkinkle(olhpk-law.com
City,State,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S)
Kelly A. Scott
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
1003 N. Cherry Street,Apt. 88
Address(Number and Street) Address(Number and Street)
Mt. Carmel, IL 62863
Under f enalties of . -rjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct
an• c• pl, e r•4uired •y aw,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
aill_ alLe•L I
Sig.amre ofSa'r Signature of Seller .
Ke A. Se 5/b2018
Printed Name of Seller Sian Date Oaf/DD/rYYYI Printed Name of Seller Slqn Date fMM/DD/YYYYI
F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT APPLY
Jerry Scott,Jr.
I.
Buyer Name as appears on conveyance document Buyer 2-Name as appears on conveyance docume
638 E. Eagle Crest Drive
Address(Number and Street) Address(Number and Street) �/
Patoka, IN 47666 "4y
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT
1>
YES NO CONDITION ' YES NO CONDITION .4
0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead V/T.
residence? Provide complete address of primary m
residence,including county: ❑ 4.Solar Energy Heating/Cooling System
❑ 13 5.Wind Power Device
Address(Number and Street) ❑ 12 6. Hydroelectric Power Device
City. ZIP Code County ❑ 12 7.Geothermal Energy Heating/Cooling Device
❑ 0 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 ❑ 12 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)
2-0C-a5 — Son — COO 5¶1-o no
CityState ZIP Code County
Primary property owner contact name E-mail