P100 QuillinINSTRUCTIONS:
Sign all copies.
Keep one copy for your records.
Return two copies in the enclosed stamped return envelope.
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: Phillip D. Quillin and Margaret A. Quillin.
ADDRESS: 2122 E. 106th Street
DESCRIPTION OF PROPERTY: Part of the W of the SE of S6- T17N -R4E, Hamilton
County, Indiana
PROJECT: Keystone Parkway
PARCEL: 100
COUNTY: Hamilton
PURCHASE PRICE: $41,693.00
ADMINISTRATIVE SETTLEMENT: -0-
IMPROVEMENTS: $41,693.00 DAMAGES: -0-
LAND AND /OR
I (we) certify tha a: i ve is true and correct and acknowledge receipt of payment.
Fee Owner(s)
Si
nature
CLOSING STATEMENT
Date
1 0
Signature Date
CITY OF CARMEL
BUYER'S REPORT (1)
PROJECT 07 -08; Keystone Parkway PARCEL 100 COUNTY Hamilton CODE N/A
NAME ADDRESS OF OWNER Phillip D. Quillin and Margaret A. Quillin
2122 E. 106 Street, Carmel, IN 46032
NAME ADDRESS OF PERSON CONTACTED
2122 E. 106 Street, Carmel, IN 46032
(List other interested parties on reverse side including nature of their interest)
DATE ASSIGNED 1/15/08 DATE OF CONTACT 1/29/08 TIME OF CONTACT 2:00 pm
OFFER 40,001.00 TYPE OF CONTACT: PERSONAL VISIT, (X) TELEPHONE CALL, (X) MAIL
Write: YES, NO or N/A (for Not Applicable), as appropriate, in each numbered blank space:
1. YES Checked Abstract with owner?
2. N/A Any affidavits taken?
3. NO Any mortgage(s)?
4. N/A Any other liens, judgments, etc.?
5. N/A Showed plans? Explained take?
6. N/A Explained about retentions?
7. N/A Any major item retained?
8. N/A Any minor item retained?
9. N/A Walked over property?
10. N/A Arranged for owner to pay taxes?
11. NO Secured Right -of -Entry?
12. N/A Secured Driveway Right -of -Entry?
Phillip D. Quillin
REMARKS: Mr. Phillip Quillin telephoned in response to the message that I had left. As we had previously spoken
in December he was familiar with the project. I explained that the appraisal phase had been completed and I
needed to present a monetary offer for the purchase of the required right -of -way. I provided the option to meet
for the presentation of the offer or it could be mailed "certified Mr. Quillin preferred mailing. Consequently, the
pertinent forms and related information were mailed via "Certified mail, Return Receipt Requested on February
1, 2008, with a date of delivery on February 2, 2008. Included within the packet were the following
forms /documents: an introductory letter, the booklet, "ACQUISITION, Acquiring Real Property for Federal And
Federal -Aid Programs and Projects and the letter acknowledging its receipt, the Confirmation of Opportunity to
Accompany Appraiser on Inspection, the Statement of the Basis for Just Compensation, the Appraisal Report, the
Uniform Land or Easement Acquisition Offer letter, the Warranty Deed with Exhibits "A" and "B the Sales
Disclosure Form, the Accounts Payable Voucher, the Request for Taxpayer Identification Number and Certification
(Form W -9), the "Owner's Private Appraisal Letter and the highlighted plan sheet. The Uniform Land or
Status of Parcel: Secured, Condemned, -Other (Explain)
Distribution Made:
(X) Parcel Attorney
(X) Owner Other (Specify)
Weekly Summary
State Form 2601 (R2/3 -91)
PHONE 317.846.2948
PHONE 317.846.2948
13. N/A Sent Daily Notice to Relocation Section?
14. NO Secured W -9 Form?
LEFT FOLLOWING PAPERS WITH OWNERS: MAILED
15. YES Written Offer?
16. YES Land Acquisition Brochure?
17. YES Retention Letter?
18. YES Statement of Just Compensation?
19. N/A Tax memo (interim period)?
20. NO Receipt of Conveyance Instrument?
21. YES Copy of Conveyance Instrument?
22. YES Owner's Appraisal Letter?
23. N/A Brochure, "Relocation You
,g1_ a
(Signt'ture) Elizabeth A. Sullivan
Page 1 of 2
State Form 20625 (R/5 -90)
BUYER'S REPORT (1)
PROJECT 07 -08; Keystone Parkway PARCEL 100 COUNTY Hamilton CODE N/A
REMARKS (Cont'd): Easement Acquisition Offer letter, in accordance with I.C. 32 -24 -1, provides only 30 days
from its receipt to accept or reject the City's offer. The 30 days may be waived and the offer accepted or rejected
now or at anytime during this period. It was also indicated that the legally protected rights and options under
Indiana's eminent domain law are set forth on page two of the Uniform Land or Easement Offer Letter, as well as
within the booklet, "ACQUISITION, Acquiring Real Property for Federal and Federal -Aid Programs and Projects
It was explained that typically, the City makes payment within 90 days after receiving the secured parcel file from
the consultant and Indiana law dictates that possession of the property will transfer to the City thirty (30) days after
payment is received. The introductory letter mailed in conjunction with the offer explained that the project is to
improve N. Keystone Parkway and E. 106' Street. More specifically, a portion of the subject property is required
as permanent right -of -way. The permanent acquisition, known as Parcel 100, contains 0.115 acres, of which 0.019
acres is existing right -of -way under pavement. As explained in the form, "Owner's Private Appraisal Letter Mr.
and Mrs. Quillin may submit an independent appraisal for review at their own expense. The forms /documents
requiring signatures and notarization were indicated. Mr. and Mrs. Quillin were encouraged to call with any
questions.
Signature
Page 2 of 2
Date
CITY OF CARMEL
BUYER'S REPORT (2)
PROJECT 07 -08; Keystone Parkway PARCEL 100 COUNTY Hamilton CODE N/A
NAME ADDRESS OF OWNER Phillip D. Quillin and Margaret A. Quillin
2122 E. 106' Street, Carmel, IN 46032 PHONE 317.846.2948
NAME ADDRESS OF PERSON CONTACTED Phillip D. Quillin and Margaret A. Quillin
2122 E. 106 Street, Carmel, IN 46032 PHONE 317.846.2948
(List other interested parties on reverse side including nature of their interest)
DATE ASSIGNED 1/15/08 DATE OF CONTACT 2/11/08 TIME OF CONTACT 9:20 pm
OFFER 40,001.00 TYPE OF CONTACT: (X) PERSONAL VISIT, (X) TELEPHONE CALL, MAIL
Write: YES, NO or N/A (for Not Applicable), as appropriate, in each numbered blank space:
1. N/A Checked Abstract with owner? 13. N/A Sent Daily Notice to Relocation Section?
2. N/A Any affidavits taken? 14. NO Secured W -9 Form?
3. NO Any mortgage(s)?
4. N/A Any other liens, judgments, etc.?
5. N/A Showed plans? Explained take?
6. N/A Explained about retentions?
7. N/A Any major item retained?
8. N/A Any minor item retained?
9. N/A Walked over property?
10. N/A Arranged for owner to pay taxes?
11. NO Secured Right -of- Entry?
12. N/A Secured Driveway Right -of -Entry?
REMARKS: Mr. Quillin telephoned and requested a meeting. An appointment was scheduled for 9:00 am on
February 14 At the prearranged time, I met with Mr. and Mrs. Quillin at the subject property. The plans were
reviewed and the project discussed, specifically as it affects the subject property. The proposed right -of -way was
indicated. Typical appraisal methodology was discussed. Mr. and Mrs. Quillin inquired of the start and completion
date of the project. They also inquired if the trees, which are within the acquisition area, were to be removed as part
of this project. f explained that the construction limits are not indicated on the plans, therefore I cannot determine
such. I further explained that although the trees may not be affected by this project, should it become necessary in
the future to remove them, it will be at the City's discretion. Mr. and Mrs. Quillin requested verification that the trees
will not be removed as part of this project. They are also obtaining an estimate to replace the trees that are being
acquired by the City. They will forward it to me upon its receipt. Their requests /inquiries were forwarded. It was
explained that it is likely that the trees will be removed as part of this project. Mr. Quillin stated that response was
not acceptable. It was also explained that the project is projected to begin in March or April with a completion date
Status of Parcel: Secured, Condemned, -Other (Explain)
Distribution Made:
(X) Parcel Attorney
(X) Owner Other (Specify)
Weekly Summary
State Form 2601 (R2/3 -91)
LEFT FOLLOWING PAPERS WITH OWNERS:
15. N/A Written Offer?
16. N/A Land Acquisition Brochure?
17. N/A Retention Letter?
18. N/A Statement of Just Compensation?
19. N/A Tax memo (interim period)?
20. NO Receipt of Conveyance Instrument?
21. N/A Copy of Conveyance Instrument?
22. N/A Owner's Appraisal Letter?
23. N/A Brochure, "Relocation You
QC
(Sign ure) Elizabeth A. Sullivan
Page 1 of 2
BUYER'S REPORT (2)
PROJECT 07 -08; Keystone Parkway PARCEL 100 COUNTY Hamilton CODE N/A
REMARKS (Cont'd): by the end of the near. Mr. and Mrs. Quillin was later provided a letter from Mr. Michael
McBride, Director of Engineering City of Carmel stating that the trees would not be removed as part of this project,
however, the City of Carmel will own the trees and reserves the right to remove them when it deems necessary.
State Form 20625 (R15 -90)
g ic-(4)
Signature
Q- 2 log
Date
Page 2 of 2
CITY OF CARMEL
BUYER'S REPORT (3)
PROJECT 07 -08; Keystone Parkway PARCEL 100 COUNTY Hamilton CODE N/A
NAME ADDRESS OF OWNER Phillip D. Quillin and Margaret A. Quillin
2122 E. 106 Street, Carmel, IN 46032 PHONE 317.846.2948
NAME ADDRESS OF PERSON CONTACTED Phillip D. Quillin and Margaret A. Quillin
2122 E. 106 Street, Carmel, IN 46032 PHONE 317.846.2948
(List other interested parties on reverse side including nature of their interest)
DATE ASSIGNED 1/15/08 DATE OF CONTACT 2/26/08 TIME OF CONTACT 3:00 pm
OFFER 41,693.00 TYPE OF CONTACT: (X) PERSONAL VISIT, (X) TELEPHONE CALL, (X) MAIL
Write: YES, NO or N/A (for Not Applicable), as appropriate, in each numbered blank space:
1. N/A Checked Abstract with owner? 13. N/A Sent Daily Notice to Relocation Section?
2. N/A Any affidavits taken? 14. YES Secured W -9 Form?
3. NO Any mortgage(s)?
Distribution Made:
(X) Parcel Attorney
(X) Owner Other (Specify)
Weekly Summary
LEFT FOLLOWING PAPERS WITH OWNERS: MAILED
4. N/A Any other liens, judgments, etc.? 15. N/A Written Offer?
5. N/A Showed plans? Explained take? 16. N/A Land Acquisition Brochure?
6. N/A Explained about retentions? 17. N/A Retention Letter?
7. N/A Any major item retained? 18. N/A Statement of Just Compensation?
8. N/A Any minor item retained? 19. N/A Tax memo (interim period)?
9. N/A Walked over property? 20. YES Receipt of Conveyance Instrument?
10. N/A Arranged for owner to pay taxes? 21. N/A Copy of Conveyance Instrument?
11. YES Secured Right -of -Entry? 22. N/A Owner's Appraisal Letter?
12. N/A Secured Driveway Right -of -Entry? 23. N/A Brochure, "Relocation You
REMARKS: Upon receipt of Mr. and Mrs. Quillins' estimate to replace their trees, it was forwarded for the City's
consideration /approval. Upon approval, I contacted Mr. Quillin and explained that the City had approved an
increase in the amount of $1,692.00. An appointment was scheduled for March 3r at 9:30 am to provide Mr. and
Mrs. Quillin with the revised forms /documents reflective of the administrative settlement.
3/3/08 (9:30 am) At the prearranged time, I met with Mr. and Mrs. Quillin. Mr. Quillin inquired if Keystone Parkway
is to be lowered. The cross section indicates that Keystone Parkway is to be lowered approximately eight feet (8')
at the 106 Street intersection. Mr. Quillin also inquired if 106 Street will be closed during construction. It will be
closed and the detour will be from Westfield Blvd. to 116 Street. The revised documents were signed and
notarized. The Hamilton County Treasurer was contacted on March 11, 2008, and it was verified that the taxes
are paid current. The Receipt of Conveyance Instrument was mailed to Mr. and Mrs. Quillin.
Status of Parcel: Secured, Condemned, -Other (Explain)
62 kiL,
(Signature) Elizabeth A. Sullivan
State Form 2601 (R2/3 -91) Page 1 of 1
DDULY ENTERED FOR TAXATION
Subject to final acceptance for ransfer
L day of Q 2041L
,e 0-61;L, hty'2 4 Auditor of Hamilton County
Parcel R/W
WARRANTY DEED
GRANTORS: Phillip D. Quillin and Margaret A. Quillin
2008021064 WARR DEED $24.00
04/21/2008 11:17:51A 5 PGS
Jennifer J Hayden
HAMILTON County Recorder IN
Recorded as Presented
Project: 07 -08; Keystone Parkway
Parcel: 100
THIS INDENTURE WITNESSETH THAT Phillip D. Quillin and Margaret A. Quillin
(individually and collectively the "Grantor convey and warrant to the City of Carmel, Indiana (the
"Grantee for the sum of Forty -one Thousand Six Hundred Ninety -three and NO /00 Dollars ($41,693.00)
and other valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the following
described real estate in Hamilton County, State of Indiana:
See attached Exhibit A and B, which are attached hereto and incorporated herein
Subject to any and all easements, agreements, restrictions and other matters of record.
It is understood between the parties hereto, and their successors in title, and made a covenant herein
which shall run with the land, that all real estate herein described (excepting any parcels or portions thereof that
are specifically and expressly designated as easements or temporary rights of way) are conveyed in fee simple
and not merely for right of way purposes, and that no reversionary rights whatsoever are intended to remain in
the Grantor.
IN WITNESS WHEREOF, Grantors have caused this Warranty Deed to be executed this 3 day of
2008.
a.
Printed: Phillip D. Quillin Printed: Margaret A. Quillin
Title: Title:
STATE OF Z NDl k
SS:
COUNTY OF itiV
Before me the undersigned, a Notary Public in and for said County and State, personally appeared
Phillip D. Quillin and Margaret A. Quillin
who acknowledged the execution of the foregoing Warranty Deed for and on behalf of such Grantor, and who,
having been duly sworn, stated that the representations therein contained are true.
WITNESS my hand and Notarial Seal this 3 day of MA-C4 2008.
My Commission Expires: O t O'lf.61c. 5 )m3
County of Residence: MV/4 N
Send tax bills to: One Civic Square, Carmel, IN 46032
831464v1
NOTARY CERTIFICATION
2
Notary' Signature
C_I ZNger j4 A
Notary Printed Name
0
I■V O U r
This instrument was prepared by Douglas C. Haney, Carmel City Attorney, City Hall, One Civic Square,
Carmel, Indiana 46032
After recording, return deed to: Douglas C. Haney, Carmel City Attorney, City Hall, One Civic Square, Carmel,
Indiana 46032
I affirm, under the penalties for perjury, that I have taken reasonable care to redact each and every Social
Security number from this document, unless it is required by law. :+j6 i 1145 C: 1 '4 4 Y y