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HomeMy WebLinkAboutSales Disclosure Form • rr�r�a SALES DISCLOSURE FORM State Form 46021(R5/6-05) PRIVACY NOTICE: The telephone 101111 11111 I 1111 numbers of the parties on this form are Prescribed by Department of Local Government Finance confidential according to IC 6-1.1-5.5- �;"'` Pursuant to IC 6-1.1-5.5 3(d). 7876 M4 aPART 1-To be completed by"BUYER/GRANTEE and SELLER%GRANTOR`(typed or printed in black ink) :f Part of Parc Parcel Number(s) (Show additional parcels on separate sheet if necessary.) Acreage or Lot Size (spl JJJJJJJJJJJJJJJJJJJJJJJJJ JJJJJJ o _ JJJJJJJJJJJJJJJJJJJJJJJJ JJJJJJJ a JJJJJJJJJJJJJJJJJJJJJJJJ JJJJJ 0 W Address #of Parcels z 251 Second Street SW JJJ City, or Post Office State ZIP Code '1=s° Y, re Carmel 11_,J1 JJJJJ - JJJ W., Q..y Tax Billing Address(if other than property address) 0, G.% One Civic Square City,Town,or Post Office State ZIP Code fp Carmel JJ A111111/1 - JJJJ Legal Description } Part of 25-18-3 Identify all conditions/items that apply NOTE: If items 12-21 apply,filers are not subject to disclosure filing fee. O1-Buyer is an adjacent property owner O 12-Security interest documents such as mortgages or trust deeds. O2-Vacant Land O 13-Leases less than 90 years O3-Exchange for other real property("Trade") O 14-Document resulting from foreclosure,or express • O 4-Seller Paid Points;amount if applicable threat of foreclosure,divorce court order,condemnation, probate or other judicial proceedings. $ 0, O 5-Change planned in the primary use of the property?Describe in O 15-Agreements and other documents for f-t, special circumstances. mergers,consolidations,and incorporations rZ. 0' O 6-Existence of family or business relationship between buyer and seller 0 16-Quitclaim deeds not serving as a source of title O7-Land Contract Dated: O 17-Documents involving the partition of land between tenants in common,joint tenants,or tenants by the O 8-Personal property included in transfer;amount if applicable entirety. O18-Transfer to a charity,not-for-profit or government institution O9-Significant physical changes to property between March 1 and date of sale O 19-Transfer for no or discounted consideration,or gift O10-Non-Warranty deed;specify type O 20-Rerecording to correct prior recorded document ' O 11-Partial interest. Describe in special circumstances. O 21-Easements,Right-of-way grants ar.,. Contract Date(MM/DD/YYYY) Sales Price `4" 7 / 2 2 / 2 0 0 5 $ , 9 9 0 0 0 0 Describe any unusual or special circumstances related to this sale,including the specification of any less-than-complete ownership interest and terms of seller financing. Y P 9 P Y P P 9. CO rLU • INDIANA SALES DISCLOSURE FORM Page 2 1 PART.1 -To betcompleted,byBUYER/GRANTEE and SELLER/GRANTOR(typed or printed in:black ink) Seller 1-Name or Entity as appears on deed 251, LLC Address =-- 3057 Sugar Maple Court City,Town,or Post Office State ZIP Code je Carmel JJ 4IA013.12] _1_1_1_1 v. Seller 2-Name or Entity as appears on deed a . `a. Address - City,Town,or Post Office State ZIP Code J JJJJ JJJJ Preparer Name and Address Preparer Phone J 11 F I n Hamilton Title Security, LLC 2111/1 JiIi 210101 Buyer 1-Name or Entity as appears on deed City of Carmel Redevelopment Commission Will this property be the buyer's primary Address residence? ' One Civic Square 0 Yes O No ,a City,Town,or Post Office State N I ZIP ICodde n Carmel JJ 1J2111A _ jjj] ,(..9 CO Buyer 2-Name or Entity as appears on deed 41),y a r m Address City,Town,or Post Office State ZIP Code ,.,. .; .. JJ 0101010101 - j_Li j .,:-,:: i 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". Signature of Seller Signature of Buyer ?sue Seller Sign Date / 2 2 / 2 0 0 5 Buyer Sign Date 0 7 / 2 2 / 2 0 0 5 .6) (MM/DD/YYYY) (MM/DD/YYYY) Seller Phone Buyer Phone J - yla - /21d2 L1 JJJ - JJJ - JJJJ ', it ', PART 2 COUNTYAUDITOR•; ,',` 'T, ;. P t .''PART 3.L3000NTY OR TOWNSHIP ASSESSOF2:, , County Assessor or other assessing offical must verify and complete the following information: OSignificant physical changes to property between March 1 and date of sale AUDITOR'S FILE STAMP $ AV LAND I J I Property class I Juse code . Taxing District(DLGF assigned) $ AV IMPV JJJJJ Completion O Yes O No Date Entered in Transfer Book $ AV TOTAL O Valid Sale / - / _IJ_1J IJJjJ_JJ_JNEIGNBORt.IOODCODE