HomeMy WebLinkAboutHomestead_Ross (8) _INDIANA SALES DISCLOSURE FORM SDFID: Pa•e2
D.PREPARER -- - - -- - -
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Prepare.of the Sales TM losure Form Tide.
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_ 'tss(Number and Street) Company
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City.Sta[e,and ZIP Cede Telephone Number E-mail
[F SELLER S GRANTOR S -
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Seger!-Nameesa.p rs on conveyance do omear Seiler 2-Name as appears an conveyance documen:
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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 requ bye, l`w and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
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Printed Name a Seer I Sian Date iPcsurAvmlll Printed Name o;Fz'ie Sic.;Date(Are ._y!n?Yl _
F.BUY R S GRANTEES -APPLICATIONFORPROPERTYTAXDEDUCTIONS-IDENTIFYALLITEMSTHATAPPLY
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Buyx. Name as taxers en roc.•egrnce ds¢rra: Bale.-2-Nene as cppanrs on.convey or .
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Add (Number cod S- et) I Address(isSmter and Street)
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THE SALES DISCLOSURE.FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALLHQvO' '.A — ,/
YFS NO CONDITION YES NO CONDITION OUN St
❑ 1.Will this property he the buyer's primary ❑ 3.Homestead 0/7-
residence? Provide complete address of primary ❑ G✓ 4.Solar Energy Heating/Cooling System
residence,including coon ,.,/
f-
Ilrl �� --e reL. ❑ u S.Wind Power Device'7ddress(Number cad Street) I�- � p [t ' 6.Hydroelectric Power Device
�Y t N['LI-on , �/\+ 47u70 Gil n ❑ EK 7.Geothermal Energ`Heating/Cooling Device
CET.State ZIP Code County
❑ 2.Does the buyer have a homestead in Indiana to be ❑ � S.Is this property a residential rental property?
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.
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Pal•a0•property menc:Santa¢name E-mail
:%m>;p, CLAIM FOR HOMESTEAD PROPERTY TAX YEAR I
STANDARD/SUPPLEMENTAL DEDUCTION FORM
� � State Form 5473(R1711-t6) HCIO -
Presmoed by the Department o1 Local Gotenmv v Flare '
INSTRUCTIONS:See reverse side for Wag instructions.
NOTE:Telephone.Social Security,driver's liicease.state idenru'xation and federal identification numbers are mnfdential under IC 6- . 2- 7.
I(We) Jacob M Ross certify that I(we)occupied asur) " I I
place of residence or am(are)buying the following described real property under contract for which a Homestead Pro aj Standa I
Deduction is hereby claimed on the date this application is signed December 30,2016 (date of signature). IMO ;
Own. y Am(are)buying under recorded contract %,5, 0O
Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. N
0 I Have a beneficial interest in the trust or the right to occupy the property under the terms of a qualified pe r st
0 Am(are)the shareholder, partner,or member of the entity that owns the property. NT)
_ - �_ •____ --'-CLAIMANTS INFORMATION " _ . _" - .yeJ,
Name of daraa legal rename)
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._ -. .-..
e hrlog m cantata Fee Serp4 comets name
Kimberly E Ross
Remtee's cape wive mead c recanted Rend ranter Page
Gibson County
\S:1))91 Comfy lowtsim •lama Os=(on/town,IOwrsap)
Gibson Patoka Princeton,Patoka
Parcel ranter Legal(*scoot= Is We popery.:mesdm: •
26-12-07-103-000.297-028 Devins ENLG 1PTf2PT Iii:Real property ❑Annually assessed nroae home(IC 61.141
It any pal=d an resde0al sduGie of lee tan]rot emceeing one(1)ace rat Oreclatly aroma eat structure is used to module.care.devote are use and paten
of ale watery reed to moos more.
Svc.Canty,and township Is claimant vacating a tmlestead?
None
0 Yes Fj No
sgana. da.namt I
I hereby certify the `
e above statements are true,correct.and complete.
Mews a mud(number and meet.sty stare,one ZIP rode) Address of .dir-
ii
- ..d any(nmoer and street city state.ere ZIP code)I
5841 Beaver Trail,Evansville,IN 47715
' :ASSESSOR USE ONLY _ _ _ I .:ASSESSED VALUE HOMESTEAD VALUE.; I'-- ';NON-RESIDENTIAL. :.
-
- -.VALUE
Land not exceeding one(1)acre immediately
sorroundm9 residential improvements (1)
Other land (2)
Total lard(lure 1 plea line 2) (3)
Residential improvements or Dwelling I(4) I
annually assessed mobile I
manufactured home Garage (5)
Other improvements (6) I
Total improvements(line 4 through line 6) (7) I
Toll value (line 3 plus line 7) (8) I
1 hereby certify the above is Due.correct, Suauxe dASS6w I Dan aired(eve.day lean
and complete.
Vady.g adon-SigtaNe of hatbox I Date signed(TOW;day year)
- '- - - - STANDARDDEDUCTIONALLOWANCE - - - :J.':
20 pay 20 Lesser of 60%of the assessed value of the homestead or 545,000.
Notwtthsfanrg any other emulsion.the sum of the deduction provided n IC 6-1.1-12 to a mobile home S
that is not assessed as reel property or to a manutadured home that is not assessed as real properly may
not exceed one-haf(1)7)of the assessed value of the mute Irene or mamfadured home_
' Sgiar,xe lama I Date signed toroth.day.Year)
DITRIBUiiON:Dogma]-Casey Anew.Ede-9anped COPY-Taxpayer
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