HomeMy WebLinkAboutHomestead_Conner19 N. W. FOURTH ST.. STE 500
��rys���^E�fBVILLE, IN 47708
Company
Telephone NumbQ
Email
Sdfer' •. '--"-+�nncanve�vnredocvmen[
so� E. �as S .
Addras (Numbu and Sveet
�f r3rar�c� l �1 �{ � lo � �
C/ry, SMtq andLPCode
�/
Under penalties of perjury, I hereby certify [hat this Sales Disclasure, to the best of my knowledge and
and com le e as •equi ed b+ a}v, and is prepared in accordance th I -1.1-5.5, "Real ro e les
l ; ;`
la� � 0. \ �
' S�gnoNr<o 1y Slgna 'cb !e�_ j �;i /
Ck� — .�-4. �' a� �/a :, ..
�
RinledNv Si nDaCt MM 00 AintedNameo Shcer
F RfSI/GRANTEEfSI - APPLICATION OR PROPERTY TAX DEDUCTIONS- IDENTIFY ALL ITEMS THAT A
Bvyrr 1- Name as appears on ronve�vnce da
, RI�10 �. 113
Addrns um ran eef
F `�.�^�--
Ciry, Smfe, apnd7lPCade '/` (
FORM MAY BE USED TO APPLY FOR CERTAIY OEDURIONS
❑ 1. Will this property be the buyer's prim
residence? Provide wmplete address
Ciry, ro PCOde Counry
❑ 2. Does [he buyer have a homestead in Indiana [o be
vacated for [his residence? If yes, provide
comple[e address of residence being vacated,
including tounty:
Addrm (Number and StreeQ
Ciry, Smte ZIPCode
Covnry
Buyer2 � Name as appmrs om m�veyonce dacumen[
Addr�s (Number and Sceet)
Ciry, Srn[q and7JPCode
is true, correct
�svre Ad".
�" ❑ _ 3. Homestead j
❑ �� 4.SolarEner�Head��/CoolingSystem
❑ [� 6. Hydroelectric Power Device
❑ � 7. Geothermal Energy Heatlng/Cooling Device
❑ [� 8. Is [his property a residential rental property?
❑ [ti]� 9. Would you like to receive ta�c sta[ementr for this
property via e-mail? (Provide contactinformation
6elow. Pfease see ins ' nsfurmorctiy(ormador
Notavailablei countles) \
�'G i9-�� S��'
oa
Under penaldes of perjury, l hereby cerdfy that this Sales Disclosure, to the best of my Imow e, corred
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Ac[°. (No[e:
Spouse informadon, Social Security and Driver's Liceuse/Other numbers are oot necessary if no Homestead Deduction is
bein�/ �,
L l e�/-
_�S[qnontreof uyer7 � . ^ � ne� O � '� I -�C� � S{qnamrro/BUyer2/Spoase '
u � l_.F)
Pnnted Legal Name aJBuyc 2/Spouxe
5(qn Dott (MM/DD/YYY)]
LastSdigi6ojBuyer] e LastSDigitso/Social5ecuriryNum6er I Las[Sd(qitro%Buyerl/SpouseDriver'S Sm[e Lat[SDigitro%SocialSerunry
License/ID/OtherNum6er Num6er Lirente/!D/OtherNumber
I
� ;, CLAIM FOR HOMESTEAD PROPERTY �AX
CREDITISTANDARD DEDUCTION
♦ / State Fwm Sa73 (R6 / a-03)
Prescnbed by t�e Departmem ol Local Govemment Finana
INSTRUCTIONS: See revcrse side /oi filing fnslrur,linns.
�33�'c:.t::,..,....__....,_.. .. ..a:z.+-•�_..._ �_ ., .. . ..�....��,..�
9 FORM YEAR
� HC10
� M'el _ / /(.C�(_i " / / IiC.C.C.C.!/]`Y�-� certiry t�a�qp tqe �t���
I(VJe) occupied as our principal place o( residence the following descnbed real property for which a Homestead Pfd er�y �sc redit is
❑ i(VJe) owned ❑ Are buying under contract `�j /�
� Have a benefidal interest in the entity that is liable for lhe properry taxes on the property and that owns the pro(feA�s b�u
AUD
:s,:_ . ... . _ �,.:; - . . _. .. � �,:
c :isxz'r: ''h�,2qy-`t ,rT .: - �"-` :. . :, r-:-�' � - . _ �=e:,. CONTRACT�RECORDED'. . �_,.. �- � . , : ..;`
If bv�ing on contrad, Fee Simple awner's name
Recorders otfice whera wntract is recorEed
7o.vnship
Taing
Yvv...J W �V ! � I �1 e�J `IW I `(l—� � F7a � • �T7� l�e Oro�
.�
If any portion ol the resitlenGal strucwre or the tand not exceeding one (1) acre that immediately surtounds that
o( the properry utilizetl to produce iriwme.
a�- i��� -3�� - a�. �29- ��r
�.,i'++`�.+. "':`v '�=�'" �PROPERTY�OWNED�BYCIAIMANT�IN�OTHER`COI
County Tavnship County
I hereby certify the above statements are true, coned and complete. � ature of c�nt
ddress (numberand (reet, cdy, sta(e, ZIPCOOe)
%�f� 3 �k 3�2 �,.�� ►�1�'c��' � IF
Rewrtl number
March, 20
hereby Gaimed:
nder a contract.
ITOR
Page
- - �`=r'".,.-."-.�,: -, . _
alproDerty ❑ Mobilo�lo�o(I.Qbt.fd)
is used lo praduce inwme, tlesctibe ihe use and portion
e
� i
�- „� ��� ,� � ASSESSOR-0SE ONLY �_ . TRUE TAX ASSESSED VALUE �� �HOMESTEAD ` NON-RESIDENTIAC„
.,.�y�A�.��y � ,s ,. r.,:h. . VALUE AT100%OF_TTV - � VALUE"_ � ;i'VALUE: ��� .
Land not exceeding 1 (one) acre immediately -, : " �� ` � �.
surrounding residential improvementa (�) . �. ' - ..� �
Other land (z) � - .
Tdal land (line 7 plus line 2) (g) I
Dwelling (4) . .
Residentlal improvements or Mnually � ' 4 _ _
AssessedMobilelManufacturedHwne Garage (5� :;���-f"�"'��`'Y"-:��� ••
Olher improvemenis (6)
Tnal improvements Qine 4 through line 6) I(7�
Taal value (line 3 plus line n (g�
I hereby certify the above is true, cortecl, and Signawre o1 Asseswr Date signed
complete.
Veritying actbn - SfgnaNre of fwditor Date signed
,.z;:.:-.;,5: �-'-->-;>- : � -�" - _.STANDAR�.DEDUCTIONALIOWANCE"--• .. • - . - - _ .
20 _ Pay 20 _
Lesser ot 1/2 Homes;ead -
vavauon or E35.000
S