Laserfiche WebLink
SALES DISCLOSURE <br />State Form 46021 (R2 ! 9.98) <br />Prescribed by the State Board of Tax Commissioners i998 <br />Pursuant to IC 6.1.1.5.5 <br />rsi. Approved by State Board of Accounts, 1998 <br />Notwithstanding IC 5.14-3, a sales disclo- <br />sure form is not a public record and may only <br />be used by the State Board of Tax <br />Commissioners, persons acting on its behalf, <br />or officials acting under the authorization of <br />P.L. 84-1995 Sec. 7. <br />First name(s) <br />M,I (s) <br />Last name(s) <br />Ca.t of South Bend <br />-- <br />Address (number and street) <br />1400 Count Cit B1111din <br />City, Town or Post Office <br />State ZIP code <br />I J01 <br />South Bend <br />IN 4 <br />First name(s) M L(s} Last name(s) <br />Ynetter and HenryJones <br />Address (number and street) <br />1204 Thomas Street <br />� <br />City, Town or Post Office <br />State ZIP code <br />Soptxh Bend <br />IN 46601 <br />Send tax bills and notices to this It no, provide mailing address: <br />address? ][] Yes ❑ No <br />Address (number and stree() <br />263 Maple Street <br />City, Town or Post Office <br />State ZIP code <br />South Bend <br />IN 46601 <br />County <br />Township <br />School corporation <br />St. Joseph <br />EXEMPT TRANSACTIONS see instructions on reverse side <br />Exempt transaction? If Yes, specify the exemption number <br />(see 'Exempt Transactions- on other side) <br />7 <br />Yes ❑ No <br />SALES INFORMATION <br />1. Total Sales Price <br />50 <br />PATE OF SALE <br />.00 <br />2. Seller Paid Points <br />$ <br />Month Day Year <br />3. Net Sales Price (item 1 minus item 2) <br />$ 50.00 <br />0 9 0 7 1 9 9 g 1 <br />Check ALL of the following conditions that apply to this sale: <br />f <br />❑ Transfer of entire parcel ❑ Vacant Land ❑ for other Real <br />Cl Purchase of adjoining land } <br />PropertExchange <br />{ <br />❑ Existence of a family or business ❑ Personal Property included in ❑ Condominium <br />❑ Split(s) <br />relationship between buyer and seller transfer (estimated value <br />❑ Seller provided financing $ ) ❑ Mobile Home <br />or special circumstances related to this sale, including the specification of any less than complete ownership interest, and <br />Describe any unusual <br />the terms of any seller financing: <br />County Auditor must verity and complete the following information: <br />❑ Buyer and Seller Information ❑ Sales Price <br />❑ Address of Property Transferred ❑ Conditions of Sale <br />❑ Date of Sale ! Transfer <br />County Assessor must verify and complete the following information <br />Cl Significant physical changes to property between March 1 and <br />date of sate <br />❑ Current Property Record Card Attached <br />Property Class / Use Code: <br />Parcel / Key Number: <br />Warranty Deed? ❑ Yes ❑ No <br />ASSESSED VALUE AV INFORMATION <br />AV land: $ <br />AV Improvemant(s): $ <br />AV Total: <br />The parties to a real property conveyance are required to fife this form and attest in writing and under the penalties of perjury that the information contained <br />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. <br />Under Penalties of Perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and complete <br />as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". <br />Sig e o seller o epres tt a <br />Telephone number <br />Date signed (month, day, year) <br />Michelle <br />L. Engel <br />( ) <br />219 235--9241 <br />9 22 99 <br />Iure of buyer or representative <br />Telephone number <br />{ ) <br />Date signed (month, day, year) <br />