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
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_ 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
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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.
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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
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