Closing Documents Christine Davis - 106th StreetCLOSING STATEMENT
Section 6045 of the Internal Revenue Code, as amended by the Tax Reform Act of 1986,
requires the reporting of certain information on every real estate transaction. The information
provided below, except for the tax identification number, is adequate information to provide to a
tax professional.
FEE OWNER: Christine 8. Davis
ADDRESS: 2141 East 106th Street, Carmel, IN 46032
DESCRIPTION OF PROPERTY: A part of the NE corner of the NW 4 of Section 7,
Township 17 North, Range 4 East, Hamilton County,
Indiana
PROJECT: 106th Street — Keystone to Westfield Blvd
PARCEL: 11 COUNTY: Hamilton
CLOSING DATE: PURCHASE PRICE: $15,350.00
LAND AND/OR ADMINISTRATIVE SETTLEMENT: $ 0.00
IMPROVEMENTS: $15,350.00 DAMAGES: $15,350.00
I (we) certify that the above is true and correct and acknowledge receipt of payment.
Fee Owners
Signature
t - I3oy
Date
Signature Date
DULL -U,
111 E. WAYNE STREET, 3RD FLOOR
FORT WAYNE, IN 46802-2600
317-977-1160 612-316-0869
Account Number: A ('comm Nome:
XXXXXXXX0000 CARMEL WATERWORKS DEPO 2008
VUIU 0 MUNI NJ Al- 1 tK ISSUt OA] t
Pur
MI Iron/ n 77t< nsunJ Three Hundred h,111 om100; IOU Dollars
is the Order O/`
CHRISTINE B DAVIS, TRUSTEE OF THE
CHRISTINE B DAVIS REVOC LIVING TRUST
RIGHT OF WAY - DIVISION OF PARCEL 11
919
Due:
November 2, 2009
Amount
********$15,350.00
Author cd Slgumure
000 260866 2811' 1:09 2905 LRB': 49900 24 28 7o
Please detach check along per/oration
CHECK NO: 26086628
Aeramrr( Number- A cram' Name: Dole:
XXXXXXXX0000 CARMEL WATERWORKS DEPO 2008 November 2, 2009
Paid To:
CHRISTINE B DAVIS, TRUSTEE OF THE
Principal Amount:
For: ********$15,350.00
PROJECT DISBURSEMENT
RIGHT OF WAY - DIVISION -OF PARCEL 11
CTS CMES FORT WAYNE IN
CORPORATE TRUST SERVICES
MAC N8622-033
111 E. WAYNE STREET, 3RD FLOOR
FORT WAYNE, IN 46802-2600
317-977-1160 612-316-0869
JO
CHR13'I'i
HE B DAVIS , 'TRUSTEE OE THE
CHP LSTINE 6 DAVIS REVOC LIVING TRUST
III
111
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11
11
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JO 000006 000014 01686
Check Number.
26086628
Acruun[ Nrrrnhee
III
11
XXXXXXXX0000
******$15,350.00
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