Homestead_Wingerter INDIANA SALES DISCLOSURE FORM SDF ID: 2018 Page 2
D. PREPARER
Teresa S. Holifield
Prepare(of the Sales Disclosure Form Title
605 SE Martin Luther King Jr Boulevard Southwestern Indiana Land Title
Address(Number and Street) Company
Evansville, Indiana 47713 _ (812)425-0055 teresa @swinland.com
City, State,and ZIP Code Telephone Number E-mail
E. SELLER(S)/GRANTOR(S)
Verturia R.Quiggins
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
3340 Busy Bee Ln.
Address(Number and Street) Address(Number and Street)
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true, correct
a t co p -te as -quired by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
iti ( , ,e�4,/
I Signature of Seller -- e20 nab y Signature of Seller
h iait�t-�, LPs.R ti4 A�
Verturia R.Quiggins �{ 4
Printed Name of Sellc)r 1 Sign D to(lrf}vf/DD/YYYY) Printed Name of Seller Sign Date(MM/DD/YYYY)
F. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL ITEMS THAT APPLY
Derick B.Wingerter ThalitaA. Flo d-Win•erter
Buyer 1-Name as appears on conveyance document Buyer 2-Name as appears on convey�� •ccu•--nt
7328 Mallard Pt. 7328 Mallard Pt. . • r',,
Address(Number and Street) Address(Number and Street) - - a,
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENfIfr'B$hj�d��A7GAPPLY.
Y� NO CONDITION YES NO CONDITION
te'TY AUDfTOR
❑ 1. Will this property be the buyer's primary ) ❑ 3. Homestead
residence? Provide complete address of primary ❑ /4. Solar Energy Heating/Cooling System
residence, including county:
❑ i "s. Wind Power Device
205 W 600 S ID �6. Hydroelectric Power Device
Address(Number and Street)
Fort Branch, IN 47648 I Gibson' ❑ 7. Geothermal Energy Heating/Cooling Device
- City, State ZIP Code County ❑ 8. Is this property a residential rental property?
, El 2. Does the buyer have a homestead in Indiana to be ❑ 9. Would you like to receive tax statements for this
vacated for this residence? If yes, provide complete property via-email? (Provide contact information
address of residence being vacated, including county: below. Please see instructions for more information.
, I I I
l-132,Q, . etc& POI J r- Not available in all counties.)
Address(Number and Street)
')Gr\)SJ Lit L! N-1-1(I Uat, utl- 2. CP-iM - I-1 - 3oa000 833 oa5
City, State ZIP Code unty Primary property owner contact name E-mail
te, CLAIM FOR HOMESTEAD PROPERTY TAX YEAR
STANDARD/SUPPLEMENTAL DEDUCTION FORM
aAle Stare Fam 5173(81711-16) HC10
Prescribed by be Department S Leal Gtnaama Franca
INSTRUCTIONS:See reverse side trifling insbudoos
NOTE Telephone,Social Seaaityt dnve:s license,stale denS5ca5on and federallrlenblica6on numbers are cortsen!al under IC 6-1.1-12-37. g�
l Mme) x�i t/C yC/ �-7 lug t�0 /1 nrTTn P '� that I(vie) d,. �a8/j®/
place of residence a am(are)buying the following desaibed real property undaLCamaa far vetch a Homestead f}Dp Tax Standard
Deduction is hereby claimed DD the date this application is signed, male of Signature). I AK(We): 9 26'18
❑ Own ❑ Am(am)buying under recorded contact. K
❑ Am(are)entitled to ocapy as a tenant-stockholder of a cooperative housing corporation-
❑ Have a beneficial interest N the bust or the right to oc ipy the property under the terms of a quantified personal ce
❑ Am(are)the shareholder. partner,or member of the entity that owns the property.
AUDITOR
..
- -
C
•
arey Tovmshp Taxing dsetd KAY,towwnMarsM.P�)�A
PaaISUR'er ✓✓)r L4- r I
Legs dasaptm is the grocery in fires ac
Rear ROpste ❑A.kmmay assessed motes reins(IC 6-1.1-7)
II any paten d the reSeOS awn or the lad not eossing on(1)axe Aar en neda*y mesa est strumae ls used b caeca bare,emote be use and carbon
d are popery utbed to praise barn
L& -) 9Q71/4)Go coo Fa3czS
ST -t.PROPERTY OWNED ELSEWHERE 9YGlAIh'ANT
Stye.Canty,and Tommie) Is claimant vacating a homestead?
• Yes ❑ No
pl daueaa
I hereby certify the above statements are true,Correct,and complete. a .
) . y Mb
Address d mtact(nats-and sbae(tits ads,and ZIPr de) Address d vaaba bansssad,l •
AASta GOO Ft.Brays 1, N L17b4$ °y ordained.city.aaa.adzPma)
.ASSESSOR USE ONLY - . -7." ASSESSED VALUE:- HOMESTEAD VALUE i; NO;!RESIDENTIAL -
Land not exceeding omit)acre Immediately
residential-
Sorroumliing residential (1)
Other land
Total land(line line 21 (3)
R alimproveemerts or I Dwatthg (A) rat 2.
annually assessed mobs e/
manufactured home Garage (S) .'.-,s _°_7..-..a u12..f --'(.'
Omer improvements (6) - T:'A-;.- 41::12(?-'e?::-'' -_
Total improvements(line 4 through line 6) (7)
Total value (line 3 pha line 7) (8)
1 hereby certify the above is true,correct, S'IDetre atAsnessa Data eared(mordL day,year)
and complete.
vetybg Mon-Signature&Amite Data sigee(aaa dig.yea,)
e
20_pay 20 Lesser of 00%of the assessed value of the homestead or$45.000.
NoMehsandng any other provision,the sum of the deductions povided n IC 6.1'_12 be noble hone $ MAR 1 9 2018
that is not assessed as teal property or to a manufactured home that is not assessed as real pmpet may
not exceedone-had(1/2)at the assessed value of the mobile lone or manufactured harm
Sigma alAuto-et Gas'Voce( day,yea)
aslwwrnON:Oryud-CaayAamm,Faa-sranpedCopy-Tageyer • GIBSON COUNTY AUDITOR
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