HomeMy WebLinkAboutSales Disclosure .<0"T"---t, SALES DISCLOSURE ".t`'PRIVACYNOTipt,;,; `r ;r
d I' State Form 46021(R219-98) Notwithstanding IC 5-14-3,a sales disclo-
sure form is not a public record and may only
5..•,,, I,. Prescribed by the State Board of Tax Commissioners 1998
- �J Pursuant to IC 6.1.1.5.5 be used by the State Board of Tax
�\ %a Approved by State Board of Accounts,1998 Commissioners,persons ailing on its behalf,
eee or officials acting under the authorization of
P.L.84-1995 Sec.7.•Part I,1 To be.completed by BUYER and'SELLER(see tnStruchons on reverse side)
First name(s) M.1.(s) Last name(s)
WLB Associates,Inc.
ill Address(number and
C1`sti eq c�
� 4 cjiy,Town or_{4(OPOSt Office M a Stale ' ZIP_code
,.:g Q.-ACZ rsn�Z. rat. ' o3'
:` First name(s) M.I.(s) Last name(s)
.;:i City of Carmel Redevelopment Commission
jy Address(numb/err and street)
: .
OnI E CtV re, ''1V acLe..
,,,City,Town or Post Office State ZIP code
l` 4to0
1.v.Send tax bills and notices to this If no,provide mailing address:
;}`,address? See Below
❑Yes LE No
t,=Address(number and street)
W,f
W W :City,Town or Post Office State ZIP code
fir 7,:Count Township School corporation
Y
44=,4til ?' t3'4Wg. rs;.146': .Y.,.EXEMPT TRANSACTIONSr(see'.inst?ctions:on rev'erse:skiej« 1?r., ,St. ?s^;gla-SY A`P-;3 :;
Exempt transaction? If Yes,specify the exemption number
(see"Exempt Transactions"on other side)
❑Yes 0 N
SALES INFORMATION
1. Total Sales Price 7."tn s" kaV4 i 'YV. I
DATE OF SALE :' -$ 6D000D OOi�:ml .:
2. Seller Paid Points -s reAW R -}'• __"i-'
,�'�$ `�t1 1 >_ Srillea ,
Month Day Year ate' w ;x,31 ,{ 'r
c: f:3'� r 3v 0'i ,2 4 01;•f;'" 0',.,,0 3. Net Sales Price •(item •1 minus item 2) S 600065'0045--4-:'>t r =
ti`.n> i..rr n...._.,.C..,�72, .-. ?.r,,r�.. ...r.`.'�'k�fz:s+ �.r'r�'i,n rt vRrsys .. CL�a- �..
Check ALL of the following conditions that apply to this sale:
®Transfer of entire parcel ❑Vacant Land El Exchange for other Real ❑Purchase of adjoining land
Property("Trade")
❑Existence of a family or business ❑Personal Property included in ❑Condominium ❑Split(s)
relationship between buyer and seller transfer(estimated value
❑Seller provided financing $ ) ❑Mobile Home
Describe any unusual or special circumstances related to this sale,including the specification of any less than complete ownership interest,and
the terms of any seller financing:
Fee Simple
, ,_ 5 Part 2,4 To be;completedrby:the.COUNTY4AUDITOR`(see Instructtonson reverse side).„ ,_ .
County Auditor must verify and complete the following information:
❑Buyer and Seller Information ❑Sales Price Parcel/Key Number: 16-09-25-16-01-010.000,013,011,012
❑Address of Property Transferred ❑Conditions of Sale
❑Date of Sale/Transfer Warranty Deed? ❑Yes ❑No
' Part 3>;vTo,be completedby the COUNTY ASSESSOR?(see instrlictitins on reverrseiside). ^. ` ' -_
County Assessor must verify and complete the following information: ASSESSED VALUE(AV)INFORMATION
�- C; tom- 5
ID Significant physical changes to property between March 1 and „„,,,z+ � ?��` t�?�.,anti«;y��a
date of sale �_.m-�. :,:riz:_w '�;t'e:4;�,.;:...,i:j"�ti
0 Current Property Record Card Attached $ = } ;AV Improvement(s): } T, ` .,3-
s ,ate.;` _i*i:) .T rsi.r>'v
Property Class/Use Code: AV Total: $ -r'.*4,r£, t : t ,
.:- ; • >;' ;;.Part 4=:Signature and Verification:Section(see instructions on reverse side), ;• - '
The parties to a real property conveyance are required to file this form and attest in writing and under the penalties of perjury that the information contained
herein is true and correct. A person who knowingly and intentionally falsifies or omits any information required on this form commits a Class A infraction.
Under Penalties of Perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,cofrect 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 s e representative Telephone number Date signed(month,day,year)
..j�"'�///% (3(7) I-6.-zs-7.- 3130 .o 0
Sign ore of b -r or r''re -,- e Telephone number Dat si ned( nth.day,year)
. 4)roQNC-vv (5)1) 63i - 9 oon 36 ao