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Homestead_Ahlberg •=mow CLAIM FOR HOMESTEAD PROPERTY TAX YEAR rill r` STANDARD/SUPPLEMENTAL DEDUCTION FORM Sera Fo n 5473(R17(1-16) HCCO Prssabel by Ile Depots t at Lod Garment Rana INSTRUCTIONS:See reverse side forging bubucboos. NOTE Telephone,Social SeamfX driver's'cense,state Wenb5Ca5an end federal Welndrbcavm mmbrs are pdllldengal ,.-:Irel :T., ' 1 CERTIFICATION STATEMENT - 171 ` _ t(We) �a. / )ce ythat I(we)•. 1. 'Lunt• ,:t r•..zl • place of residence or am(are)buying the following described real property und: mmract for what a Homestead Property Tax Standard Deduction is hereby claimed on the date this application is signed, (date of sinrteiami IYVR)-Z 019 ❑ Own. ❑ Am(are)buying under recorded contract _ )Y)Hf\ O ❑ Am(are)entitled to occupy as a tenant-stockholder of a cooperative housing corporation. ❑ Have a beneficial interest in the bust or the right to occupy the property under the terns of a qualified peregl Les i ❑ Am(are)the shareholder, partner,or member of the entity that owns the property. e • . • . s RITOR . CLAIMANT'S INFORMATION _ . • Name of claimant(bgetmtm) Social �. 1 e , Shot Seeder uaMm of damn smuts The clots) ,simae(tla ion n Other ouster of derma%spouse pass Ise digest bsthg a soda'rem3yatatat / /` - - - - • _ ,�CONTRACT RECORDED ' if buying mantra* --Smote mean name J�// •. `4 �C2 i Remedefs office to contract is recorded / Record nmher Rego -. PROPERTYOESCRIPTIoNt.•- .__ --_ - . ' County beast* Taint areal(Scr Iowa toonhlp) • 17 t 44-Zentedt-- Pad cumber legs deso r Air.;Re property ingrmtbnc .Q�aeV A_a2 /53/ { ❑Real property ❑Annually assessed motes home(1C6-1.1-n It any pasts d the reeidatel strums a the lad riot emedm as(1)ape end irti aely strands Mat snare is used b moare income describe the use aid parboil of tte property tt3 ed b precise imam. A 6, - /9 -l8 — 3o„3.- oDO. 3SLI - 0 ; � _ -. . PRDPERWOWNED ELSEWHEREE BY-CLAIMANT, -. _ Raft.Caasy,aid TwmNp •. Is claimant vacating a homestead? 0 Yes 0 No I hereby certify the above statements are tree,correct,and complete. L d dermal h'I�ta,f-/�/(-y/ MLess dafad o (mmbaard shd(e off,ste.'u,and 21Pcnl) dm veb m dhomee a mrd�sef,d,fairy(number at shoe atl➢Pm6) l0, Al arc A c9 &b. ASSESSOR USE ONLY _ .,I ,;ASSESSED VALUE::_4 HOMESTEAD VALUE?-' NO4!ESIIDENTIAL,-^'e Land not exceeding one(1)acre Immediately (1) 'sue ram' r, a surrounding residential improvement . Other Wad (2) *'s::.c� _*�f�_.�t-:.'::�: Total land(line 1 plus fine 2) (3) Residential improvements or Dwelling (4) }: annually assessed mobile l ; -a. ria manufactured home Garage (5) s. 4_�xa Other improvements (6) Z`s, si _ ,.i N=ai Total improvements(km 4 through lino 6) (7) Total value Ome 3 phis line T) (a) I hereby certify the above is true,correct, SignaturedAssessp Gate signed(north.day.)dal and complete. Verifying&ecn-Signature d Amber Date signed(matt dry,)ea) _. _ %STANDARD DEDUCUONALLOWANCE ' ' - - ., - ` _ 20_pay 20 Lesser of 60%of die assessed vdue of the homestead or 345,000. . Nohsifnatdntbng any other provision,the sum of the deductions provided in IC 6-1.1-12 o a mobile home $ that is not assessed es real property or to a manufactured home that is not assessed as real property may not exceed one-haf(12)o the assessed vale of the mobile home ormanrdacW2M home, 5'qusa &Audio' Deb (m• a( a MY,)ear) DrSTRIBURON:Odgbvl-Canty Ate.FtStanped Copy-Taxpayer ' Page 1 of 2 INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARER • Leon C Stone Attorney Preparer of the Sales Disclosure Form Title 222 W Broadway St Leon C Stone Attorney Address(Number and Street) Company Princeton, IN 47670 - City,State,and ZIP Code Telephone Number Email E.SELLER(S)/GRANTOR(S) - . • Harrison G Hughes Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 3409 Terry Point Dr Address(Number and Street) Address(Number and Street) Fort Collins CO 80524 Telephone Number E-mail Telephone Number E-mail - Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and omplete as required by law,and is prep red in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act". 1hCM..>- . G .l,t,,..Q,, Jim, �P ti L Signature of Seller a t�"_ _ 0 Signature of Seller Harrison G Hughes 2 "' /e /9 r-1 _���'}} Printed Name ofSeller Sian Date(MM/DD/ITYY) Printed Name of Seller RSA(FM/DD/mY) F.BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS Michael A.Ahlbey _ She I a as appears on conveyance document Buyer2-Name aEar s appears on conveyance d 102 N Church St. 102 N Church St Address(Number and Street) Address(Number and Street) /t' /I JJZ� Fort Branch, IN 47648 Fort Branch, IN 47648 �lN'I�(,`av��',"1"�",`„�""(' Email THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THA PLY. YES NO CONDITION YES _—NO--COADITI Q ❑ 1.Will this property be the buyer's primary C❑ 0 3. Homestead residence? Provide complete address of primary ❑ © 4.Solar Energy eatin Ing System residence, including county: ❑ ❑ 5.Wind Power Device 102 N Church St Address(Number and Street) ❑ 2 6.Hydroelectric Power Device Fort Branch, IN 47648 Gibson ❑ z 7.Geothermal Energy Heating/Cooling Device City,State ZIP Code County 0 02. Does the buyer have a homestead in Indiana to be ❑ 0 8. Is this property a residential rental property? vacated for this residence? If yes,provide ❑ gi9.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) 26 v- iy-i Q , 3 03 - 0 a 0 •3Sy-o..16 City,State ZIP Code County Primary property owner contact name E-mail 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 6-1.1-5.5,"Real Property Sales Disclosure Act". (Note: License/ID/Other Number Number License/ID/Other Number