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HomeMy WebLinkAboutHomestead_Thompson1q. FIRE PARER Preparer of the Sales Disclosure Form Title Rowand, Tina AGENT Company Email Address Telephone Number ServiceLink, LLC Tina.Rowand@svclnk.com 11-115-53-3121-1 Address (number and street, city, state, country, and ZIP Code) 1355 Cherrington Parkway Moon Township, PA 15108 I. SELLERS)/GRANTOR(S) Seller 1 — Name as it appears on conveyance document Seller 2 — Name as app of c veya ce do um t Logan A. Thompson Address (number and street) Address (number and street) 7506 Harvey Ln Jill City, State, and ZIP Code City, State, and ZIP Code - Owensville IN 47665 Country Country i Email Address Telephone Number Email Address ulbz>u N -r elephone Number ( ) ( 2 17,)G3 069 Under penalties of perjury, I hereby certify 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 A person who knowingly and intentionally falsifies the value of transferredv,m real property, or omits or falsifies any information required to be provided, commits a Level 5 felony. SignatureAf Sel Signature of Seller ted Na e o Seller Date Signed (mm/dd/yyyy) Printed Name of Seller Date Signed (mm/dd/yyyy) Logan A. Thompson J`.:BuYER(S)/GRANTEE(S) - APPLICATION FOR PROPERTY TAX DEDUCTIONS - IDENTIFY ALL THAT APPLY Buyer 1 — Name as it appears on conveyance document Buyer 2 — Name as it appears on conveyance document Logan A. Thompson Rebecca Thompson Address (number and street) Address (number and street) 7506 Harvey Ln 7506 Harvey Ln City, State, and ZIP Code City, State, and ZIP Code Owensville IN 47665 Owensville IN 47665 Country Country Email Address Telephone Number Email Address Telephone Number ( >I ( 10 Z' 0 4 Pursuant to IC 6-1.1-12-44, the Sales Disclosure Form may be used to apply for certain deductions. Identify all of those that apply: YES NO CONDITION YES NO CONDITION © ❑ 1. Will this property be the buyer's primary ❑O ❑ 3. Homestead residence? ❑ ❑p 4. Solar Energy Heating or Cooling System ❑ ❑✓ 5. Wind Power Device 2. Does the buyer have a homestead to be vacated ❑ for this residence? If es, provide address: y p ❑ O✓ 6. Hydroelectric Power Device ❑ ❑Q 7. Geothermal Energy Heating or Cooling Device n—� Address (number and street) City, State, and ZIP Code County 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 6-1.1-6.6. A person who knowingly and intentionally falsifies the value of transferred real property, or omits or falsifies any information required to be provided, commits a Level 5 felony. (Note: Both spouse's 40brmation, SSAUDdver's LicenselfD/Other Number is necessary only if a Homestead Deduction is being filed.). Signature u S' t re of Buyer 2/ pouse Pjktfed L!egoXa5he of Buyer 1 Sigfi Date M/DD/YY) Pri ted CeVal Name of Buyer OSpouse Si aI M/DD/YY) Logan A. ompson Rebecca Thompson Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number Page 3 _t"s. - CLAIM FOR HOMESTEAD PROPERTY TAX YEAR STANDARD/SUPPLEMENTAL DEDUCTION FORM State Form 5473(R15I614) HC10 Prescribed by the Decal:men of Local Goverment Finance INSTRUCTIONS:See reverse side for filing instructions NOTE:Telephone,Social Security,drivels license,state identification and federal identification numbers am confidential u 611-1:37 i _ .- ,y _., - CERTIFICATION STATEMENT ''- 1 • a` r t NJ!, -'r r - I I(We) A J _/i .x11✓.f�_�� certify that I(wce)�!w.. as 7.'i�'i....' e4•TION place of resid- ce or am(are)buying the following de • .:-• real property under contract for which a 4 n� y- f.r transfer Deduction is hereby claimed on the date this applira5on is signed, (date ofa' ) . I O ____❑ Own. ❑ Am(are)buying under recorded contract ❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation, a••❑ Have a beneficial interest in the trust or the right to occupy the property under the terms of a • -, ,. r.,cV j/y� e"rlp, t❑�,A�udiit�or� ❑ Am (are)the shareholder, partner, or member of the entity that owns the property. t S i O.1 TY AUtl79VT!ountY ____ _ If bysg on contact,Fee Simple camels name Recorder's oLce where contract is recorded Record number I Page ,-`4.v` irir'i it;--c -t _._-e P,ROPERTY,DESCRIP,TION Fief-r 3r,W51 .a •T:G`tliO4 i Cary Township Taaig risaidd Katy,town,tonnsht) Parcel camber L I d " Is the sty in q yti t.�� question: d- /L /2-- ❑Real property Annuely assessed moble borne(IC 6-1.1-7) If arty porton of the re idenial tom es a the land not exoeedeg one(1)ace that immedIYlf surrounds that sometime is red to produce income,desaibe the use and nodal of the property utrme to produce income. ,,,,i6 -l7-aa - %oo -oo $ - 0 /Z. -_o1.7 . _ ',PROPERTY OWNED ELSEWHERE BY CLAIMANT Sass,Carey,and Township Is claimant varadng a homestead? . ' ❑ Yes ❑ No -,f Wenare I hereby certify the above statements are true,correct,and complete. of contact(number and sleet,city,state,and ZIP cede) ,dairy(numbaerd Street,oty state.and BR“de) Owwsu'Ur %isQ A �• U •N .I s .1 I .I ., s•s I .INONR SID NTIAL VALUE Land not exceeding one(1)acre eats immediately (1) t,'y'�' surrounding residential improvements Other land (2) Total land(line 1 plus line 2) (3) -- - Residential improvements or Dwelling (4) Annually Assessed Mobilel Manufactured Home Garage (5) Other Improvements (B) „ . ''t`-- Total Improvements(line 4 through line 6) (7) Total value (line 3 plus line 7) (S) I hereby certify the above is true,correct, Signature of Assessor Date signed(month,day,seed and complete. • Vestyhg action-Signature of AUdar Date signed(month,day,year) g- � ,,..4 '-�A.2..7 �'-a'y"BSTANDARD DEDUCTION'ALLOWANCEIg-M'�a:? IjZM ; 20 pay 20 Lesser of 60%of the assessed value of the homestead or$45,000 i , j 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/alproperty or toe manufactured home that is not assessed as real property may DEC 27 2016 not exceed one-half 1/2 of the assessed value of the mobile home or manufactured home. Sigrevre of Audior Date signed(month day,year) :ia_ _S' • i -grim Tr 0r71rr• DISTRIBUTION:Orgval-Corny Audtoor.FieSamped Copy-Taxpayer GIBSON COUNTY AUDITOR