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Homestead_Holden (2) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 V!PRE PARERisr�s''',�;`ts�ira+ -.�_-n C.Michael Witters _ Attorney at Law Preparer of the Sales Disclosure Form Tide 1001 Oak Street Address(Number and Street) Company Mt.Carmel,IL 62863 618-262-8725 wttrlaw @aol.com City,State,and ZIP Code Telephone Number E-mail • E^SEIiliER(S)%GRANTOR(S)': .' �;t :_.i'_ '`^ 3t 'ti Matthew L.Holden • Rebekah J.Holden Seiler I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 1550 N. 100 W. 1550 N. 100 W. Address(Number and Street) Address(Number and Street) Princeton,IN 47670 Princeton, IN 47670 . Under penalties of perjury,1 hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete ad �- s required by law,and is prepared in accordance wi IC 6.1, -5.5,"Real Prpperty Sa s Dis ure Act". Signature of Seller Slgnamrenf,SenerluJt�l.11 1 �y�It�jjCf MATTHEW L. HOLDEN 6-1- 16 REBEKAH J. HOLDEN era-J(, Printed Name of Seller 'Sign Date{MAIMOJYYn) Printed Name of Seller Slpn Datenal/DD/YYY1) 2 :FSBU,TER(S)`/,GRANTEE(S) W8CICATION,EOR`PROP,ERT,YeTAX+DEDUETTONSa1DENTIP.TALL'LITEMS;THAVAP,Plie__ 1 Rodney S.Holden Julie A. Holden Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 1550 N. 100 W. 1550 N. 100W. Address(Number and Street) Address(Number and Street) Princeton, IN 47670 Princeton,IN 47670 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 NO CONDITION ❑ 1.Will this property be the buyer's primary p ❑ 3.Homest d residence? Provide complete address of primary ❑ Is 4.Solar Energy - /C,�d}yl System residence,including county: ���iii i4.4o N. too w, ❑ 19 5.WindPowp/',Device 'Address(Number and Street) ❑ 0 6.Hydroelectrt Iiwer Devi Princeton, IN 47670 Gibson G City,State ZIP Code County ❑ 0 74 of ji al Energy ing/Cooling Device• ❑ 5 2.Does the buyer have a homestead in Indiana to be 111 0 8.Is • ••e r residential rental property? vacated for this residence? If yes,provide ❑ 12 9.Would yotr „r?!���' : e tax statements for this complete address of residence being vacated, property via a-filrj j (Provide contact information including county: below.Please see i .Q/qrAians for more information. Not available in all coun'tNs.) Address(Number and Street) _ CLAIM FOR HOMESTEAD PROPERTY TAX YEAR .`-r% - STANDARD/SUPPLEMENTAL DEDUCTION FORM ' >• State Form 5473(R15/5-14) HC10 Prescribed by the Department of Local Government Finance INSTRUCTIONS:See reverse side for filing instructions. NOTE:Telephone Social Security,driver's license,state identification and federal identification numbers are confidential under IC 6.1.1-12-37. t^ �j�r-a." }, IT;r:CERTIFICATION STAMMER-1—F' p- •tt-°•9 J. ._.' 4. f,t .n .r;•• I(We) ;T ice' I '• /71(4:J/f , certify that I(we)occupied as my(our)principal place of r- idence or am(are .ng the oil• f g described real property under contract for which a Homestead Property Tax Standard Deduction is hereby claimed•1T e date this a.•fication is signed, (date of signature). I(We): ❑ Own. ❑ Am(are)buying under recorded contract ❑ Am (are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. ❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified personal residence trust . ❑ Am (are)the shareholder, partner, or member of the entity that owns the property. a,_'1 — .. i CLAIMAirrl INFORMATION "; .„ F _- .,..,, .e. NamE ant(legal name) Teleyhone umber of ddtmaa�ntt U Socianumber suinJJII 113.3 V I l of ant(last five dgds) Diverts license/Itleraifodm/Odvf number Issuing State Oo 8 ^ of claimant(last fiedyss) Ioaa' o 17 P Name 1 darvra's spouse I(/egal nane) ' number of davrarta spouse(last five diyLS) Darter's 5ce.se/IderoSratien/Other number 1 Issuing Data of cla::ants spouse(last fix 6gss) s M• =� _i-f£-`.'-`iW �'=TCONTRACT.RECORDED`: A:buying m m 4 rtra Fee Simple owners tame 1':) • Recorders o5ce where contract o recorded Record number Page AP' • 20 Al J S_f6-` gs :.z'.' .yPERTY:DESCRIP-TION=f,,1 Y8--4Ysd v' .Z -- Gamy To+msNp Taxing d¢bid(may,town,toens4e) Partel rimiber 1 legaldescipton a are ' °° GIBSON COUNTY AUDI1iOR ❑Real property ❑ Annual/assessed neWe hone(/C 64.1-7) d any canon of the residential s^,xaxe or the land not esceed^g one(1)acre that'v:v:cdv:ey surrounds that sta5re is used to produce income,dasm a the use and poi of the popery V.S¢ed to produce vtmne. a(PH1 .. 01'co0 ©o4 . ccoa- oa '? • . . _ PROPERTY OWNED ELSEWHERE BY CLAIMANT • _ •_ - , • _,-_ Ras.Courfy,and Tovmship Is claimant varatng a homestead? • ❑ yes ❑ No Sgm^• of claimant I hereby certify the above statements are true,cored,and complete. c 14694 cl- ■ Address of corad(=most and street.ray,are,end ZIP Ode) va hwes:ead.Emy(number end treat.cry,&a:e.and LE cede) ir . ► D• . 4 ..a.$ 1- 6?v - _ • - • ASSESSOR USE ONLY ASSESSED VALUE HOMESTEAD VALUE ' NON-RESIDENTIAL -_yALUEn-_. ' Land not exceeding one(1)acre immediately 11) ( --- �F ..'•x1[ surrounding residential Improvements - Other land (2) Total land(line 1 plus line 2) (3) ___ Residential improvements or Dwelling (4) I Annually Assessed Mobile I - sy'��.�^.a Manufactured Home Garage (5) I _- - '7--` • Other improvements (6) I .;;;vi)-.72'.. -a:"..•."54 Total improvements(line 4 through line 6) (7) Total value (line 3 pins line 7) (8) I hereby certify the above Is true,correct, I Signature of Assessor Date signed(manta,day,year) and complete. Vecyt g action-Signature ofAudio/ Date signed(mr.h,day,year) .r�. g .: i'"O. ,M;:e i„y STANDARD DEDUOTONACLOWANCEI` 20 pay 20 Lesser of 60%of the a«csed voue of the homestead or 545,000 Notwithstanding any other provision,the sum of the deductions provided in IC 6-1.1-12 to a mobile home $ that is net assessed as real property or to a anufactured home that is not assessed as real propery may not exceed on If(12)of the assessed ue of the mobile home or manufactured home. sgrux• of _ /� Drs signed(m ear.year) DISTRIBUTION: Odgial-CountyAid:: r,Fie-Stamped Copy-Taxpayer