Homestead_WilzbacherE�"n ; CLAIM FOR HOMESTEAD PROPERTY TAX
���� CREDIT/STANDARD DEDUCTION ,
.,,�y .;��� State Form Sa73 (R2 / 5-92)
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INS7RUCTIONS: See ieverse side lor7iling instructions.
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FORM 1'EAR
HC70
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I(We) � � / � certiE .t at on ihe 7 d�f Marc 79
�) occupie as our principal place o r idence ihe tollowing described ieal property for which a Homestea P perty f_�g �,{;.� I' ed:
V I(We) owned ❑ Are buying under wniract - - , ' C! �: n:d !.ni!�fT'; .='.�D'TOR
❑ Have a beneticial interest in ihe entity that is liable for the property taxes on ihe pmperty and thai owns ihe pmperty or is buying under a contract.
� � � _ . CONTRACTRECORDED - � - �
It buying on conirad, Fee Simple owner's name . • ' '
Recordefs office where contract is recorded Record number Page
—V /�� ��a
resitlential struaure or the land
�ed �o produce income.
PROPERTY DESCRIPTION .
�� s� a�-3 -i� �.s �� pc
one (1) acre that immediatety wrmunds that structure is used to produce income, tlescribe the use and portion
-/9-01�- �'a- a6� ��9-Q�s
� ASSESSOR USE ONLY TRUE TAX - ASSESSED HOMESTEAD NON-RESIDENTIAL
VALUE VALUE VALUE VAWE
Land not exceeding 7(one) acre immediately
surrounding residential improvements. (�) �
Otherland (Z)
Total land (line 1 plus line 2� (3)
- Dwelling (4)
Residential improvements
Garage (5) �
Oiher improvements (6) _
Total improvements (line 4 througA line � (7)
Total value (line 3 pLs line � (g�
I hereby Certity the above i5 lme. CArreCt. and Signature ot Assessor Dare signed �
complete.
V�fying action - Sgnature ot Auditor I Date signetl
19_Pay19_
Lesser of 1/2 Homestead
Valuation or 32.000
Signamre
DEDUCTION
S
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
ETIMRRERARERr-; _ _ :4--L, l . ,. " .- -C - - ,'^ - -!g - '-'
CHRISTINA LATHAM TITLE CLERK
Preparer of the Sales Disclosure Form Title
4703 THEATER DRIVE REGIONAL LAND TITLE
Address(Number and Street) Company
EVANSVILLE. IN 47715 812-402-4553 CHRISTINA(a)REGIONAL-LT.COM
City,State,and ZIP Code Telephone Number E-mail
(E SELLER(S/GRANTiOR(S)1 z .. •r" .. `„'r• i- .:%. r, t„ -a'; ` - : ' '
•
•
-Jan M Wilzbacher - -
- „1/4
teller I-Name as appears on conveyance decamp! Seller 2-N'ame as appears on conveyance document
15 1 C Si-ct+C I d h o K" A_p+ I n t
') _ _ Address(Number and Street)
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 plete as require by law,and is prepared in accordance with IC 6-1.1-5.5,"Real Property Sales Disclosure Act".
na[tl Seller V Signature of Seller
Jan M bather 'I,a / -6 -
P ameo a SitarfiiErHM/DD-- Printed Name of Seller Sian Date(M.N/DDIYYYY)
0311YR(S'UGI:e01111U(S.CiAlielii.GATIQNFORMROREKEYLTIAXWEDROITONSQ1DENIFIVAH 1.1•• i Ir -
Ti
'Daniel K.Wilzbacher d
ameosu nveyance document Buyer 2-Name as appears on conve nce cnculn'prif
Slild 'dndStt-eei)l Address(Number and Street) EC 1 7 2018
X,rgJ s ,i `f7L 3S
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a. Ni
(InnmEeiL_� E-mail Tele hone Number GIBSON COUN I Y /yUD.TCR E-mail
TCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THI OPE IDENTIFY ALL SE THAT APPLY.
E.Y -_CONDITION?, S nO1"7CONDITIO.N>_-'
1.Will this property be the buyer's primary ❑ 3.Homestead
residence? Provide complete address of primary
LA, gy-Heating/Cooling System
residence,including county:
2458E 950 S ❑ 0S.Wind Power Device
Address(Number and Street) ❑ Q 6.Hydroelectric Power Device
Haubstadt, IN 47639 Gibson ❑ Q 7.Geothermal Energy Heating/Cooling Device
City,State ZIP Code County
❑ ❑ 2.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 ❑ ❑✓ 9.Would you like to receive tax statements for this
complete address of residence being vacated, rapertYvta�mait: e contact information
including county: below.Please see instructions for information.
Not available in all counties.)
Address(Number and Street) •
-192,8 4400-ooi .2 -0Zs—
City,State ZIP Code aunty
Primeryp owner contact name frfail
Number License/ID/Other Number