Fillable Madison County Assessor Sales Disclosure (Indiana)

Fill Online, Printable, Fillable, Blank Madison County Assessor Sales Disclosure (Indiana) Form

Use Fill to complete blank online STATE OF INDIANA (IN) pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Madison County Assessor Sales Disclosure (Indiana)

On average this form takes 28 minutes to complete

The Madison County Assessor Sales Disclosure (Indiana) form is 3 pages long and contains:

  • 0 signatures
  • 62 check-boxes
  • 82 other fields

Country of origin: US
File type: PDF

U.S.A. forms for State of Indiana

BROWSE STATE OF INDIANA (IN) FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
SALESDISCLOSUREFORM
StateForm46021(R11/12‐11)
PrescribedbyDepartmentofLocalGovernmentFinance
PursuanttoIC6‐1.1‐5.5
PRIVACYNOTICE:ThetelephonenumbersandSocialSecuritynumbersofthepartiesonthisformareconfidential
accordingtoIC61.15.53(d).
SDFID
Count
y
Year
UniqueID
SDFDate:__________________________
PART1
–TobecompletedbyBUYER/GRANTEEandSELLER/GRANTOR
A.PROPERTYTRANSFERRED–MUSTBECONVEYEDONASINGLECONVEYANCEDOCUMENT
1.PropertyNumber
Checkboxifapplicableto
parcel
5.CompleteAddressofProperty 6.CompleteTaxBillingAddress(ifdifferentfrom
propertyaddress)
A.)
2.Split
3.Land
4.Improvement

7.LegalDescriptionofParcelA:
B.)
2.Split
3.Land
4.Improvement

7.LegalDescriptionofParcelB:
B.CONDITIONS–IDENTIFYALLTHATAPPL
Y
C.SALESDATA– DISCLOSEVALUEOFITEMSLISTEDINTABLEB,
ITEMS1‐15
Ifcondition1applies,filerissubjecttodisclosureandadisclosurefilingfee.
1.Conveyancedate(MM/DD/YYYY):_________________________________________________
2.Totalnumberofparcels:
_______________________________________________________
3.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.
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
YES NO CONDITION
1.Atransferofrealpropertyinterestforvaluable
consideration.
2.Buyerisanadjacentpropertyowner.
3.Vacantland.
4.Exchangeforotherrealproperty("Trade").
5.Sellerpaidpoints.
(ProvidethevalueTableCItem12.)
6.Changeplannedintheprimaryuseofthe
property?
(DescribeinspecialcircumstancesinTableCItem3.)
7.Existenceoffamilyorbusinessrelationship
betweenbuyerandseller.
(CompleteTableCItem4.)
8.Landcontract.Contractterm
(YY):________________________
andcontractdate(MM/DD/YYYY):______________________________
9.Personalpropertyincludedintransfer.
(Providethevalue
TableCItem5.)
10.PhysicalchangestopropertybetweenMarch1
anddateofsale.
(DescribeinspecialcircumstancesinTableCItem3.)
11.Partialinterest.
(DescribeinspecialcircumstancesinTableCItem3.)
 12.Easementsorright‐of‐waygrants.
YES NO CONDITION
4.Familyorbusinessrelationshipexistingbetween
buyerandseller?
Amountofdiscount:$
________________________________________
Discloseactualvalueinmoney,property,aservice,anagreement,orotherconsideration.
Ifconditions1315apply,filersaresubjecttodisclosure,butnodisclosurefilingfee.
5.Estimatedvalueofpersonalproperty: $
YES NO CONDITION
6.Salesprice: $
13.Documentforcompulsorytransactionsasa
resultofforeclosureorexpressthreatof
foreclosure,divorce,courtorder,judgment,
condemnation,orprobate.
14.Documentsinvolvingthepartitionofland
betweentenantsincommon,jointtenants,or
tenantsbytheentirety.
15.Transfertoacharity,not‐for‐profitorganization,
orgovernment.
YES NO CONDITION
7.Isthesellerfinancingsale?Ifyes,answer
questions(8‐13).
8.Isbuyer/borrowerpersonallyliableforloan?
9.Isthisamortgageloan?
10.Amountofloan: $
11.Interestrate: %
12.Amountinpoints: $
13.Amortizationperiod:
Reset Form
INDIANASALESDISCLOSUREFORM SDFID:_________________________________ Page2
D.PREPARER
______________________________________________________________________________________________ ______________________________________________________________________________________________
PrepareroftheSalesDisclosureFormTitle
______________________________________________________________________________________________ ______________________________________________________________________________________________
Address(NumberandStreet)Company
______________________________________________________________________________________________ ______________________________________________________________________________________________
City,State,andZIPCodeTelephoneNumber Email

E.SELLER(S)/GRANTOR(S)
______________________________________________________________________________________________
Seller1Nameasappearsonconveyancedocument
______________________________________________________________________________________________
Address(NumberandStreet)
______________________________________________________________________________________________
City,State,andZIPCode
______________________________________________________________________________________________
TelephoneNumber Email
______________________________________________________________________________________________
Seller2Nameasappearsonconveyancedocument
______________________________________________________________________________________________
Address(NumberandStreet)
______________________________________________________________________________________________
City,State,andZIPCode
______________________________________________________________________________________________
TelephoneNumber Email
Underpenaltiesofperjury,IherebycertifythatthisSalesDisclosure,tothebestofmyknowledgeandbelief,istrue,correct
andcompleteasrequiredbylaw,andispreparedinaccordancewithIC61.15.5,"RealPropertySalesDisclosureAct".
______________________________________________________________________________________________
SignatureofSeller
______________________________________________________________________________________________
PrintedNameofSeller SignDate
(MM/DD/YYYY)
______________________________________________________________________________________________
SignatureofSeller
______________________________________________________________________________________________
PrintedNameofSeller SignDate
(MM/DD/YYYY)
F.BUYER(S)/GRANTEE(S)–APPLICATIONFORPROPERTYTAXDEDUCTIONS– IDENTIFYALLITEMSTHATAPPL
Y
______________________________________________________________________________________________
Buyer1Nameasappearsonconveyancedocument
______________________________________________________________________________________________
Address(NumberandStreet)
______________________________________________________________________________________________
City,State,andZIPCode
______________________________________________________________________________________________
TelephoneNumber Email
______________________________________________________________________________________________
Buyer2Nameasappearsonconveyancedocument
______________________________________________________________________________________________
Address(NumberandStreet)
______________________________________________________________________________________________
City,State,andZIPCode
______________________________________________________________________________________________
TelephoneNumber Email
THESALESDISCLOSUREFORMMAYBEUSEDTOAPPLYFORCERTAINDEDUCTIONSFORTHISPROPERTY.IDENTIFYALLOFTHOSETHATAPPLY.
YES NO CONDITION YES NO CONDITION
1.Willthispropertybethebuyer'sprimary
residence?Providecompleteaddressofprimary
residence,includingcounty:
______________________________________________________________________________________________
Address(NumberandStreet)
______________________________________________________________________________________________
City,StateZIPCodeCounty

2.DoesthebuyerhaveahomesteadinIndianatobe
vacatedforthisresidence?Ifyes,provide
completeaddressofresidencebeingvacated,
includingcounty:
______________________________________________________________________________________________
Address(NumberandStreet)
______________________________________________________________________________________________
City,StateZIPCodeCounty
3.Homestead
4.SolarEnergyHeating/CoolingSystem
5.WindPowerDevice
6.HydroelectricPowerDevice
7.GeothermalEnergyHeating/CoolingDevice
8.Isthispropertyaresidentialrentalproperty?
 9.Wouldyouliketoreceivetaxstatementsforthis
propertyviae‐mail?(Providecontactinformation
below.Pleaseseeinstructionsformoreinformation.
Notavailableinallcounties.)
____________________________________________________________________________________________
PrimarypropertyownercontactnameEmail
Underpenaltiesofperjury,IherebycertifythatthisSalesDisclosure,tothebestofmyknowledgeandbelief,istrue,correct
andcompleteasrequiredbylaw,andispreparedinaccordancewithIC61.15.5,"RealPropertySalesDisclosureAct".(Note:
Spouseinformation,SocialSecurityandDriver’sLicense/Othernu
mbersarenotnecessaryifnoHomesteadDeductionis
beingfiled.)
______________________________________________________________________________________________
SignatureofBuyer1
______________________________________________________________________________________________
PrintedLegalNameofBuyer1 SignDate(MM/DD/YYYY)
______________________________________________________________________________________________
Last5digitsofBuyer1Driver’sStateLast5DigitsofSocialSecurityNumber
License/ID/OtherNumber
______________________________________________________________________________________________
SignatureofBuyer2/Spouse
______________________________________________________________________________________________
PrintedLegalNameofBuyer2/SpouseSignDate
(MM/DD/YYYY)
______________________________________________________________________________________________
Last5digitsofBuyer2/SpouseDriver’sStateLast5DigitsofSocialSecurity
NumberLicense/ID/OtherNumber
INDIANASALESDISCLOSUREFORM SDFID:_________________________________ Page3
PART2‐COUNTYASSESSOR
Thecountyassessormustverifyandcompleteitems1through14andstampthesalesdisclosureformbeforesendingtotheauditor:
1.Property 2.AVLand 3.AVImprovement 4.ValueofPersonal
Property
5.AVTotal 6.Property
ClassCode
7.Neighborhood
Code
8.TaxDistrict 9.Acreage
A.)
 
B.)
 
AssessorStamp
10.IdentifyphysicalchangestopropertybetweenMarch1and
dateofsale._____________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
YES NO CONDITION
 11.Isformcompleted?
 12.Statesalesfeerequired?
13.Dateofsale
(MM/DD/YYYY):
________________________________________________
14.Dateformreceived
(MM/DD/YYYY):
________________________________________________
Items15through18aretobecompletedbytheassessorwhenvalidatingthissale:
15.Ifapplicable,identifyanyadditionalspecialcircumstancesrelatingtovalidationofsale._________________________________
__________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________________
YES NO CONDITION
 16.Salevalidfortrending?
 17.Validationofsalecomplete?
18.Validatedby:______________________________
PART3‐COUNTYAUDITOR
AuditorStamp
1.Disclosurefeeamountcollected:$__________________________________
2.OtherLocalFee:$____________________________________________________
3.TotalFeeCollected:$_________________________________________________
4.Auditorreceiptbooknumber:______________________________________
5.Dateoftransfer
(MM/DD/YYYY):_______________________________________
YES NO CONDITION
 6.Isformcompleted?
 7.Isstatefeecollected?
 8.Attachmentscomplete?
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _ _ _ _
PART4–RECEIPTFORSTATEMENTOFDEDUCTIONOFASSESSEDVALUATION
______________________________________________________________________________________________
SDFID SDFDate
(MM/DD/YYYY)
______________________________________________________________________________________________
ParcelNumber
______________________________________________________________________________________________
Buyer1Nameasappearsonconveyancedocument
______________________________________________________________________________________________
AddressofProperty(NumberandStreet)
______________________________________________________________________________________________
City,State,andZIPCodeofProperty
______________________________________________________________________________________________
AuditorSignature Date(MM/DD/YYYY)
Checkallthatapply:
HomesteadSolarEnergyWindPower
HydroelectricGeothermalRentalProperty
ElectronicStatement(e‐mail)______________________________________________
Apersonwhoknowinglyandintentionallyfalsifiesvalueoftransferredrealproperty,oromitsorfalsifiesanyinformationrequiredtobeprovidedin
thesalesdisclosureformcommitsaClassCfelony.
INDIANASALESDISCLOSUREFORMINSTRUCTIONS Page1
INSTRUCTIONS
Indianalawrequiresasalesdisclosureform(SDF)tobereviewedforcompletenessbythecountyassessorbeforebeingforwardedtothecounty
auditorandmustbecompletedwheneveraconveyancedocument(seedefinitionbelow)isfiled.Thecountyauditormaynotacceptaconveyanceif
(1)thesalesdisclosureformisnotincludedwiththeconveyancedocument;or(2)thesalesdisclosureformisincompleteand/orisnotstampedby
thecountyassessor.AseparateSDFisrequiredforeachparcelconveyed,regardlessofwhethermorethanone(1)parcelisconveyedundera
singleconveyancedocument.However,onlyone(1)SDFisrequiredifthereisasingleconveyancedocumentthatconveystwo(2)ormore
contiguousparcelslocatedentirelywithinasingletaxingdistrict.Apersonfilingasalesdisclosureformmarkedonlywithsalesconditionssubject
toadisclosurefilingfeeshallpayafeeoftendollars($10.00)tothecountyauditor.
Definitions
ConveyanceDocument
‐meansanytransferofarealpropertyinterestforvaluableconsiderationtoincludeanydocument,deed,contractofsale,
agreement,judgment,leasethatincludesthefeesimpleestateandisforaperiodinexcessofninety(90)years,quitclaimdeedservingasasource
oftitle,documentpresentedforrecordingthatpurportstotransferarealpropertyinterestforvaluableconsideration.Filersarerequiredto
disclose,butarenotsubjecttoafeewhenfilingthefollowing:documentsforcompulsorytransactionsasaresultofforeclosureorexpressthreatof
foreclosure,divorce,courtorder,judgment,condemnation,orprobate;documentsinvolvingthepartitionoflandbetweentenantsincommon,joint
tenants,ortenantsbytheentirety;transfertoacharity,not‐for‐profitorganization,orgovernment;oreasementsorright‐of‐waygrants.Filers
shouldnotethatthefollowingitemsdoNOTrequireasalesdisclosureformbeprepared:securityinterestdocumentssuchasmortgagesortrust
deeds;leaseslessthan90years;agreementsandotherdocumentsformergers,consolidations,andincorporationsinvolvingsolelynon‐listedstock;
quitclaimdeedsnotservingasasourceoftitle.Additionallyasalesdisclosureformisnotrequiredforatransferfornoconsiderationoragift,or
whenrerecordingtocorrectpriorrecordeddocument.
Personalproperty
–meansitemsthatarenotattached(built‐inoraffixed)totherealestate(landandbuildings).Thismightincludeitemssuchas
washers,dryers,windowtreatments,stovesandrefrigerators.Otheritemsconsideredpersonalpropertyareboatsandothervehicles,inventories
(livestock,goodsinprocessorfortrade,oragriculturalcommodities)andmachineryusedinfarmingormanufacturing.
A.PROPERTYTRANSFERRED
Asinglesalesdisclosureformmayincludemultiplepropertiesaslongastheparcelsarecontiguousandlocatedentirelyinasingletaxingdistrict.
Allparcelsandpropertylistedinthisboxmustbeconveyedonasingleconveyancedocument.Parcelsandpropertyonseparateconveyance
documentsmustbesubmittedonseparatesalesdisclosureforms.Ifthetransactionconsistsofmorethanthreeparcels,anadditionallistofparcel
numbersandlotsizesmustbeattachedtothisdocument.
1. PropertyNumber:Stateand/orlocalrequiredpropertynumber(s)(includingalldashesanddecimalsonthesalesform).Anidentification
numberthatisassignedtoaparceloflandtoidentifythatparcelfromanyotherparcelwithinagiventaxingjurisdiction.Listallparcels
separatelyusingseparateattachmentsifneeded.ShouldthesalesdisclosureformbesubmittedpriortoassignmentoftheStatemandated18
digitparcelnumber,eithertheparentparcelnumberorthenameofthesubdivisionandthelotnumberasprovidedbythecountyplanning
departmentmustbeincluded.IfthepropertyispersonalpropertythecountyassignedIDisrequired.
2. Split:Checkiftheparcelissplit,orsectionoff,fromanotherparcelincludedonthissalesdisclosureform.
3. Land:Checkifthisparcelisland.
4. Improvement:Checkifthisparcelincludesbuildingsorstructures.
5. CompleteAddressofProperty:Providethestreetaddressorgeographiclocationofthetaxablerealestate.AP.Oboxaddressisnotacceptable.
6. CompleteTaxBillingAddress(ifdifferentfrompropertyaddress):Providetheownermailingaddressfortheownerofrecord.AP.O.boxis
acceptable.
7. LegalDescription:Providealegaldescriptionofrealpropertybygovernmentsurvey,metesandbounds,orlotnumbersofarecordedplat.A
legaldescriptionisespeciallyimportantformetesandboundsdescriptionsandnewparcels.Thelegaldescriptionmaybeprovidedasan
attachmenttoand/oruploadedwiththesalesdisclosureform.
B.CONDITIONS
Theinformati
oninthissectionisusedtodeterminesalescharacteristics,establishmarketvalue,anddetermineapplicabilityofthesaleandforuse
inratioorotherstudies.Theappropriateresponseshouldbefilledinforallconditionsthatapplytothesale.Pleasenotethatwhileindicatingthat
certainconditionswillresultinnotpayingafilingfee,thebuyer/granteeorseller/grantorisstillresponsibleforcompletingtheforminfull.
1. Atransferofrealpropertyinterestforvaluableconsideration:Atransferofarealpropertyinexchangeformoney,performance,orapromise
ofperformance.
2. Buyerisanadjacentpropertyowner:Apersonwholivesonaborderoflistedproperty.
3. Vacantland:Aparcelinwhichthereisnoimprovementvalue.
4. Exchangefortheotherrealproperty(“Trade”):Anexchangeofpropertyforanotherproperty,commodity,service,oritemoflikevalue.
Tradingdoesnotrequiretheuseofmoney,howevermoneymaybeusedforaportion,butnotall,ofthetrade.
5. SellerPaidPoints:Anincentivebythesellertoacquireabuyer.
6. Changeplannedintheprimaryuseoftheproperty:Identifyiftheproperty’sclassificationwillbechangedfromitscurrentstatus,i.e.,
residentialtocommercial.Describeinspecialcircumstances,tableC,item3.
7. Existenceoffamilyorbusinessrelationshipbetweenbuyerandseller:Whetherthebuyerandsellerhaveamutualinterestinthelisted
property.
8. Landcontract:ContracttermandContractdate:Apurchaseallowingthegranteepossessionofthepropertyandthegrantorretainingthedeed
tothepropertyuntilthetermsofthecontractaremet.Thecontracttermislistedasatwodigitnumber.
9. Personalpropertyincludedintransfer:Propertythatisnotpermanentlyaffixedtoandnotapartoftherealestate,andfurtherdefinedbystate
statuteandrule.
INDIANASALESDISCLOSUREFORMINSTRUCTIONS Page2
10. PhysicalchangestopropertybetweenMarch1anddateofsale:Achangefromcurrentpropertyclassstatus,changedtoadifferentuse,i.e.,
grocerystorechangingtobowlingalley.
11. Partialinterest:Individualnothaving100%interestinsaidproperty.ProvideadescriptioninspecialcircumstancesintableCitem3.
12. Easementsorright‐of‐waygrants:Rightheldbyonepartyofsaidpropertytousethelandofanotherforaspecificpurpose.
13. Documentforcompulsorytransactionsasaresultofforeclosureorexpressthreatofforeclosure,divorce,courtorder,condemnation,or
probate:Courtorderedtransaction.
14. Documentsinvolvingthepartitionoflandbetweentenantsincommon,jointtenants,ortenantsbytheentirety:Splitofpropertybetweentwo
ormoreindividualswhoowninseparableinterestinaparcelofrealproperty.
15. Transfertoacharity,not‐for‐profitorganization,orgovernmententity:Identifyifthepropertywillbeownedbyacharity,not‐for‐profit
organizationoragovernmententityasaresultofthetransfer.
C.SALESDATA
Theconveyancedateandsalespriceofthepropertytransferistobeprintedinthespacesprovided.Anyunusualorspecialconditionsofthesale
thatmayaffectthesalespriceortermsofthesalesagreementshouldalsobedescribed.Withregardtopersonalproperty(seedefinitionsbelow),
thebuyerorsellermustenteranestimatedvalueofthepersonalpropertyincludedinthesale.Similarly,thebuyerandsellermustenterthe
amountofsellerpaidpointsasapplicable.
1. Conveyancedate:Datetheconveyancedocumentissigned.Effectivedateofthedeedordocument,orthedateofthemostrecentsignatureon
theconveyancedocument.Thisdatedetermineswhatyearthesalemaybeusedfortrendingcalculationsandmayalsobereferredtoasthe
dateofthesale.
2. Totalnumberofparcels:Totalnumberofparcelsincludedontheconveyancedocument.EachshouldbelistedseparatelyintableAabove.If
therearemorethantwoparcelsinvolvedinthetransaction,additionalparcelinformationmustbeincludedinanattachmenttothisform.
3. 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.
4. Isthereafamilyorbusinessrelationshipexistingbetweenbuyerandseller?Dothebuyerandsellerhaveamutualinterestinsaidproperty?
Statetheamountofanydiscountfrommarketvalue.
5. Provideestimatedvalueofpersonalproperty:Thisshouldbetheamountofpropertynotpermanentlyaffixedtosaidparcel.Refertonumber8
insectionB.
6. Statethepriceatwhichsaidpropertyisactuallysold.
7. Identifyifthesellerisfinancingthesale:Iftheanswerisyestothisquestion,C.SalesData,items7‐13mustbecompleted.
8. Ifsellerisfinancing,indicatewhetherthebuyer/borrowerpersonallyliableforloan.
9. Ifsellerisfinancing,identifyifthisisamortgageloan.
10. Ifsellerisfinancing,statetheamountofloanbeingfinancedbytheseller.
11. Ifsellerisfinancing,statetheinterestrateshownasapercentage.
12. Statetheamountinpoints,ifapplicable.Principalamountdeducted.
13. Ifsellerisfinancing,statetheamortizationperiodorthetimeneededtorepayaloanonsaidproperty.
D.PREPARER
Theindividualpreparingthesalesdisclosureformistoprovidefullname,title,company,fulladdress,telephonenumber,andemail.Thecontact
informationprovidedisusedbycountyofficialstovalidatethesaleandmustbevalidforatleast30daysfollowingthefilingofthesalesdisclosure
form.Telephonenumberandemailarerequestedinorderfortheassessortovalidatethesale.Telephonenumbersprovidedareretainedas
confidential.
E.SELLER(S)/GRANTOR(S)
Seller(s)/grantor(s)aretoprovidethefullname,address,telephonenumber,andemailforseller(s)orentityasapplicable.Thecontactinformation
providedisusedbycountyofficialstovalidatethesaleandmustbevalidforatleast30daysfollowingthefilingofthesalesdisclosureform.If
therearemorethantwoindividualsorentitiesinvolvedinthetransaction,additionalownershipinformationmustbeincludedinanattachmentto
thisform.Telephonenumberandemailarerequestedinorderfortheassessortovalidatethesale.Telephonenumbersprovidedareretainedas
confidential.Sel
ler(s)/grantor(s)arerequiredtosigncertifyingthatthesalesdisclosureistrue,correctandcompleteasrequiredbylaw,andis
preparedinaccordancewithIC6‐1.1‐5.5.
Thebuyer/grantee,seller/grantorortheirrepresentativesmustsignone(1)salesdisclosureform,orifthepartiesdonotagreeontheinformation
tobeincludedonthecompletedform,eachpartymustsignandfileaseparateform.Forconveyancetransactionsthatinvolvemorethantwo(2)
parties,itissufficientforone(1)transferorandone(1)transfereetosigntheSDF.Ifanyoneotherthanthebuyer/selleroranattorneyofthe
buyer/sellerissigningtheform,aproperlyexecutedPowerofAttorneymustbecompletedandattached.Apersonwhoknowinglyand
intentionallyfalsifiesvalueoftransferredrealproperty,oromitsorfalsifiesanyinformationrequiredtobeprovidedinthesalesdisclosureform
commitsaClassCfelony.
F.BUYER(S)/GRANTEE(S)–APPLICATIONFORDEDUCTIONSANDCREDITS
Buyer(s)/grantee(s)aretoprovidethefullname,address,telephonenumber,andemailforbuyer(s)orentityasapplicable.Thecontact
informationprovidedisusedbycountyofficialstovalidatethesaleandmustbevalidforatleast30daysfollowingthefilingofthesalesdisclosure
form.Iftherearemorethantwoindividualsorentitiesinvolvedinthetransaction,additionalownershipinformationmustbeincludedinan
attachmenttothisform.Telephonenumberandemailarerequestedinorderfortheassessortovalidatethesale.Telephonenumbersprovided
areretainedasconfidential.Thebuyer/granteemustalsoindicatewhetherthepropertywillbeusedasaresidentialprimaryresidence.
Buyer(s)/grantee(s)arerequiredtosigncertifyingthatthesalesdisclosureistrue,correctandcompleteasrequiredbylaw,andispreparedin
accordancewithIC6‐1.1‐5.5.Thesalesdisclosureformmaybeusedtoapplyforthehomesteadstandarddeductionforthisproperty.Individuals
INDIANASALESDISCLOSUREFORMINSTRUCTIONS Page3
filingforthehomesteadstandarddeductionmustprovidetheirfulllegalname(asitappearsintherecordsoftheSocialSecurityAdministration),
thelast5digitsofthedriver’slicense(orstateidentification)number,andlastfivedigitsoftheirsocialsecuritynumber.Inaddition,amarried
individualmustalsoprovidetheirspouse’slegalname(asitappearsintherecordsoftheSocialSecurityAdministration),last5digitsofthedriver’s
license(orstateidentification)number,andlastfivedigitsofthespouse’sSocialSecuritynumber.Intheeventthatthesenumbersarenot
available,theindividualmayuseafederalidentificationnumbersuchasthePermanentResidentCard(“A”)number.Thisinformationiskept
confidentialtotheextentpossibleunderIndianalaw.Failuretoprovidethisinformationmayresultintheinabilityoftheindividualtoreceivethe
deduction.
Whenanindividualbecomesineligibletoreceiveastandarddeductiontheymustnotifythecountyauditorofthefactwithin60daysof
thedatetheyfirstlosetheireligibility.Failuretodosomayresultinsub
stantialfinancialpenalties,includingtherepaymentofupto
threeyearsofunpaidtaxesanda10%penaltyontaxesowed.
Thesalesdisclosureformmayalsobeusedtoreapplyforitems4‐7belowtotheextentthattheyalreadyexistonthisproperty,andstateform
18865,StatementForDeductionOfAssessedValuation(AttributedToSolarEnergySystem/Wind,GeothermalorHydroelectricPowerDevice),is
onfileatthecountyauditor.Thebuyer(s)mustidentifyallthatapplytothepropertyincludedonthesalesdisclosure.Inaddition,thesedeductions
mayrequireadditionalcertificationfromtheIndianaDepartmentofEnvironmentalManagement;therefore,thebuyershouldworkwiththecounty
auditor’sofficetodeterminewhatisneededtoreceivethesebenefits.
1. Stateifthispropertywillnotbethebuyer'sprimaryresidence.Providecompleteaddressofprimaryresidence,includingthecountyofthe
residence.
2. Stateifthebuyerhasahomesteadthatwillbevacatedforthisresidence.Ifyes,providecompleteaddressoftheresidencetobevacated,
includingthecountyoftheresidence.
3. Homestead–includeshomesteadstandarddeductionandsupplementalhomesteaddeduction.Ifselectedthepropertyiseligibleforboththe
standardandsupplementaldeductionsusingthesalesdisclosureform.
4. SolarEnergyHeating/CoolingSystem–stateifthispropertyhasasolarenergyheating/coolingsystem.
5. WindPowerDevice–stateifthispropertyhas
awindpowerdevice.
6. HydroelectricPowerDevice–stateifthispropertyhasahydroelectricpowerdevice(stateform18865mustbeonfile).
7. GeothermalEnergyHeating/CoolingDeviceDeductions–stateifthispropertyhasageothermalenergyheating/coolingdevice(stateform
18865mustbeonfile).
8. Isthispropertyaresidentialrentalproperty?Identifyifthispropertywillbeusedasarentalproperty.
9. Wouldyouliketoreceivetaxstatementsforthispropertyviae‐mail?UnderHEA1344‐2009,acountymayelecttooffertaxpayerstheoption
toreceivepropertytaxbillselectronically.Inthesecountiesapropertyownermayfilewitheitherthecountytreasurerorcountyauditorto
receiveelectronicstatements.Ifataxpayerelectstoreceiveelectronicstatements,thechoiceremainsineffectuntilthetaxpayerchangese‐
mailaddresses,orrequestsotherwise.Onlyoneelectronicstatementcanbesentperproperty;therefore,thepersonorentityexercisingthe
optionmustdesignateasingleindividualtoreceivethestatement.Ifanindividualrequestselectronicstatementsinacountythatdoesnot
offerthem,thee‐mailaddresswillbehelduntilsuchtimeasthecountychoosestoadopttheoption.Ifataxpayerchoosestochangethis
preference,StateForm53954(AuthorizationforReceiptofElectronicPropertyTaxStatements)mustbefiled.
Youmayalsobeeligibleforothercreditsordeductionsforwhichseparateapplicationmayberequired.
Thebuyer/grantee,seller/grantorortheirrepresentativesmustsignone(1)salesdisclosureform,orifthepartiesdonotagreeontheinformation
tobeincludedonthecompletedform,eachpartymustsignandfileaseparateform.Forconveyancetransactionsthatinvolvemorethantwo(2)
parties,itissufficientforone(1
)transferorandone(1)transfereetosigntheSDF.Ifanyoneotherthanthebuyer/selleroranattorneyofthe
buyer/sellerissigningtheform,aproperlyexecutedPowerofAttorneymustbecompletedandattached.Apersonwhoknowinglyand
intentionallyfalsifiesvalueoftransferredrealproperty,oromitsorfalsifiesanyinformationrequiredtobeprovidedinthesalesdisclosureform
commitsaClassCfelony.
PART2–COUNTYASSESSOR
Thecountyassessormustverifyandcompleteitems1through14andstampthesalesdisclosureformbeforesendingtotheauditor.Thecounty
assessorisresponsibleforverifyingthefollowinginformationspecifictoeachparcelincludedinthesalesdisclosureform:
1. ParcelID.TheparcelIDfortheparcelscoveredonthesalesdisclosureformmustbeverifiedascorrectandvalid.
2. AVLand.Themostrecentassessedvalueofthelandforeachparcel.
3. AVImprovement.Themostrecentassessedvalueofimprovement(s)foreachparcel.
4. ValueofPersonalProperty.Themostrecentassessedvalueofthepersonalpropertyidentifiedforthisparcel,oranestimatedvalueforthe
personalpropertyidentifiedasdeterminedbythecountyassessor.
5. AVTotal.Themostrecenttotalassessedvalueforeachparcel.
6. PropertyClassCode.Thepropertyclasscodemaintainedwithinthecomputerassistedmassappraisalsystem.
7. NeighborhoodCode.Theneighborhoodcodemaintainedwithinthecomputerassistedmassappraisalsystem.
8. Validstateassignedtaxdistrict.
9. Acreage.Lotsizesmustbeconvertedtonumericacreage.
Additionallythefollowinginformationmustbeprovidedforthesalesdisclosureform:
10. IdentifyphysicalchangestopropertybetweenMarch1anddateofsale.Thecountyassessorisresponsiblefordeterminingwhetherornot
significantphysicalchangeshavebeenmadetothepropertybetweenMarch1andthedateofsale(conveyancedate).
11. Isformcompleted?Thecountyassessorhasverifiedformhasbeenproperlycompleted.
12. Salesfeerequir
ed?Thecountyassessorshouldindicateifcountyauditorshouldcollectasalesdisclosurefilingfee.Thesalesdisclosurefeeis
notrequiredfortableBitems13‐15.
INDIANASALESDISCLOSUREFORMINSTRUCTIONS Page4
13. Dateofsale.Thecountyassessorindicatesdateofsale(theconveyancedate)foruseinstatisticalanalysisandratiostudycalculations.
14. Dateformreceived.Datecountyassessorreceivedsalesdisclosureform.
Items15through18aretobecompletedbythecountyassessorwhenvalidatingthissale.Processingtheformtotheauditorisnotcontingenton
validationofthesale.
15. Ifapplicable,identifyanyadditionalspecialcircumstancesrelatingtovalidationofsale.
16. Countyassessorindicatesifthesaleisvalidforuseintrending.
17. Countyassessorindicatesthesalevalidationprocessiscomplete.
18. Signatureorinitialsofindividualvalidatingthesale.
Thecountyassessorand/orotherassessingofficialsareresponsibleforverifyingthesaleaswell.Verificationofsalesdisclosuredateisrequired
priortosubmittingsalesdatatotheDLGF.Tostreamlineandexpeditetheverificationofasale,itisstronglyrecommendedthatthecounty
assessorverifyeachsalewithin30daysofreceiptoftheSDF,astheassessormayfindthatthebuyerand/orsellermaynotbelocatedatthe
addressprovidedontheform.
Salesdisclosureformsprovidedinresponsetopublicrecordsrequestsmaynotincludetelephonenumbers.
PART3–COUNTYAUDITOR
Thecountyauditorisresponsibleforcorrectlycollectingthefilingfeeforallnon‐exemptsalestransactionsaswellasensuringthatallpartiestothe
conveyancehavecompletedandsignedtheformasrequired.Thecountyauditormaynotacceptthesalesdisclosurestatementif(1)thebuyeror
sellerfailstocompletelyfillouttheirdesignatedportionsoftheform;(2)thesalesdisclosureformisnotincludedwiththeconveyancedocument;
or(3)thesalesdisclosureformisincompleteand/orisnotstampedbythecountyassessor.Ifthebuyerorsellerfailstocompletelyfillouttheir
designatedportionoftheform,thecountyauditormaynotaccepttheconveyancedocument.Thecountyauditormustalsoconfirmthedatethe
propertywasdulyenteredfortransfer.
1. Disclosurefeeamountcollected:Entertheamountofthedisclosurefeecollectedbythecountyauditor.
2. Otherlocalfee:Entertheamou
ntofotherlocalfeescollectedforthetransferoftheproperty.Thisamountshouldnotincludethesales
disclosurefeeasrequiredbythestate.
3. Totalfeecollected:Enterthetotalamountofthefeecollectedforthistransaction.Theamountshouldequalthesumofpart3item1plus
part3item2.
4. Auditorreceiptbooknumber:Identifythereceiptbooknumberusedforcollectionofthedisclosurefee.
5. Dateoftransfer:Enterdateenteredintransferbook.
6. Isformcompleted?CheckyesiftheformiscompletedexceptforPART2‐COUNTYASSESSOR,Items15‐18,whichmaynotbecompleted
priortosubmissiontotheauditor.
7. Isfeecollected?Checkyesifasalesdisclosurefeehasbeencollectedforthissalesdisclosureform.
8. Attachmentscomplete?Checkyesiftheattachmentsrequiredtosupportthissalesdisclosureformhavebeenprovidedandarecomplete.If
therearenoattachments,checkyes.
ThecountyauditorshallrevieweachsalesdisclosureformandprocessanyhomesteadcreditoranyofthedeductionsforwhichtheSDFservesas
anapplicationunderIC6‐1.1‐12‐44[solarenergyheating/coolingsystem,windpowerdevice,hydroelectricpowerdevice,geothermalenergy
heating/coolingdevicedeductions]andIC6‐1.1‐20.9‐3.5[homesteadcreditandstandarddeduction].
Salesdisclosureformsprovidedinresponsetopublicrecordsrequestsmaynotincludetelephonenumbers.
INDIANASALESDISCLOSUREFORMINSTRUCTIONS Page5
TABLE1–DeductionscoveredundertheSalesDisclosureForm
ListedbelowarecertaindeductionsandcreditsthatareavailabletolowerpropertytaxesinIndiana.TaxpayersmayclaimthesebenefitsbyfilinganapplicationwiththeAuditorintheCountywherethepropertyis
situated.Theprevioustaxbillwillfacilitatefiling,butitisnotrequired.
Applicationsfordeductionsagainstrealpropertymustbefiledduringtheyearinwhichthedeductionissoughttobeeffectivefortaxespayableinthefollowingyear.Thefilingdeadlinefordeductionapplicationsfor
mobilehomesandmanufacturedhomesthatarenotassessedasrealpropertyisthetwelvemonthsbeforeMarch31,unlessnotedbelow.
Thedeductionwillappearonthetaxbilltheyearfollowingtheassessmentdate.Foradditionalinformationontheseandotherbenefits,pleaseconsultIndianaCode§§6‐1.1‐12and6‐1.1‐20.9.
Note:TheSalesDisclosureFormisnotanapplicationfortheHomestead,oranyotherrelevantdeductions,foranannuallyassessedmobileormanufacturedhome.
DEDUCTION
(IndianaCode)
MAXIMUMAMOUNT
** ELIGIBILITYREQUIREMENTS
APPLICATIONFORMAND
VERIFICATION(PROOF)
REQUIRED
RESTRICTIONSWHEN
COMBININGWITHOTHER
DEDUCTIONS**
HomesteadStandard
Deduction
(6‐1.1‐12‐37)
Thelesserof:
(1)sixty‐percent
(60%)ofthe
assessedvalueofthe
realproperty,or
(2)fortyfive
thousanddollars
($45,000).
1)Residentialrealpropertyimprovements(includingahouseorgarage)locatedin
Indianathatanindividualusesastheindividual’sprincipalresidence,includinga
mobileormanufacturedhomenotassessedasrealproperty;
2)Ontheassessmentdate(March1,orinthecaseofamobilehomethatisassessedas
personalproperty,theimmediatelyfollowingJanuary15)oranydateinthesameyear
afteranassessmentdate,theindividualorentityowns;isbuyingunderacontractthat
providesthattheindividualistopaythepropertytaxes;isentitledtooccupyasa
tenantstockholderofacooperativehousingcorporation;orisanindividualas
describedinIC6‐1.1‐12‐17.9andtheresidenceisownedbyatrustasdescribedinIC
6‐1.1‐12‐17.9;
3)Consistsofdwellingandrealestatenottoexceedoneacresurroundingthedwelling;
4)Onestandarddeductionpermarriedcoupleorindividual.
Note:Homesteaddoesnotincludepropertyownedbyacorporation,partnership,limited
liabilitycompany,orentitynotdescribedinIC61.11237.
SalesDisclosureForm46021or
DLGFFormHC10(StateForm
5473).Oneformfiledforboththe
HomesteadStandardDeduction
andSupplementalHomestead
Deduction.
SupplementalHomestead
Deduction
(EffectiveonJanuary1,
2009andappliesto
propertytaxesfirstdue
in2009andthereafter.)
(6‐1.1‐12‐37.5)
EqualtotheSumof
theFollowing:
(1)thirty‐five
percent(35%)ofthe
assessedvaluethatis
lessthansixhundred
thousanddollars
($600,000).
(2)twenty‐five
percent(25%)ofthe
assessedvaluethatis
morethansix
hundredthousand
dollars($600,000).
Anindividualwhoisentitledtoahomesteadstandarddeductionfromtheassessedvalue
ofpropertyunderIC6‐1.1‐12‐37alsoisentitledtoreceiveasupplementalhomestead
deductionfromtheassessedvalueofthehomesteadtowhichthestandarddeduction
appliesaftertheapplicationofthestandarddeductionbutbeforetheapplicationofany
otherdeduction,exemption,orcreditforwhichtheindividualiseligible.
SalesDisclosureForm46021or
DLGFFormHC10(StateForm
5473).Oneformfiledforboththe
HomesteadStandardDeduction
andSupplementalHomestead
Deduction.
Thisdeductionmustnotbe
consideredinapplyingthe
limitsinIC6‐1.1‐12‐40.5,
whichstatesthatthesumof
thedeductionsprovidedto
anannuallyassessedmobile
homeormanufacturedhome
maynotexceedone‐half
(1/2)ofitsassessedvalue.
*AnyunusedportionafterapplicationtoresidencepropertyappliesnexttopersonalpropertyandlastlyasExciseTaxCreditoneithermotorvehicleexcisetax(IC6‐6‐5‐5)oraircraftlicensetax(IC6‐6‐6.5).
**Thesumofthedeductionsprovidedtoamobilehomeortoamanufacturedhomethatisnotassessedasrealpropertymaynotexceedone‐half(1/2)oftheassessedvalueofthemobilehomeormanufactured
home.(IC6‐1.1‐12‐40.5)
INDIANASALESDISCLOSUREFORMINSTRUCTIONS Page6
DEDUCTION
(IndianaCode)
MAXIMUMAMOUNT
***
ELIGIBILITYREQUIREMENTS
APPLICATIONFORMAND
VERIFICATION(PROOF)
REQUIRED
RESTRICTIONSWHEN
COMBININGWITHOTHER
DEDUCTIONS**
SolarEnergyHeatingor
CoolingSystems
(6‐1.1‐12‐26)
Deductionequalsthe
out‐of‐pocket
expensesifsubjectto
assessmentand
taxation.
1)Personmustownorbebuyingoncontracttherealpropertyormobileor
manufacturedhomenotassessedasrealpropertyonthedatetheapplicationisfiled;
2)Realpropertyormobilehomenotassessedasrealpropertyisequippedwithasolar
energysystem,windpowerdevice,hydroelectricpowerdevice,orgeothermalenergy
heatingorcoolingdevice;
3)Withrespecttorealproperty,fileduringtheyearforwhichthepersondesiresto
obtainthededuction,andwithrespecttomobilehomewhichisnotassessedasreal
propertyfileduringthetwelvemonthsbeforeMarch31ofeachyearforwhichthe
deductionissought(ifmailedthemailingmustbepostmarkedonorbeforethelastday
forfiling).
Solar:SalesDisclosureForm
46021orStateForm18865
Wind:SalesDisclosureForm
46021orStateForm18865
Hydroelectric:SalesDisclosure
Form46021orStateForm
18865;and
IndianaDepartmentof
EnvironmentalManagement
(IDEM)certification,whichmay
beobtainedbymailingcopyof
StateFormtoIDEM,100N.
SenateAve.,Indianapolis,IN
46204
Geothermal:SalesDisclosure
Form46021orStateForm18865
IndianaDepartmentof
EnvironmentalManagement
(IDEM)certification.whichmay
beobtainedbymailingcopyof
StateFormtoIDEM,100N.
SenateAve.,OfficeofWater
Quality,65‐40Geothermal,
Indianapolis,IN46204
PARTIALLY‐These
deductionsmaybeclaimed
withallotherdeductions
EXCEPTtheOver65
Deduction.
WindPowerDevice
(6‐1.1‐12‐29)
HydroelectricPower
Device
(6‐1.1‐12‐33)
GeothermalDevice
(6‐1.1‐12‐34)
Deductionequalsthe
assessedvalueofthe
device.
INDIANASALESDISCLOSUREFORMINSTRUCTIONS Page7
TABLE2–OtherDeductionsNOTcoveredundertheSalesDisclosureForm
ListedbelowarecertaindeductionsandcreditsthatareavailabletolowerpropertytaxesinIndiana.TaxpayersmayclaimthesebenefitsbyfilinganapplicationwiththeAuditorintheCountywherethepropertyis
situated.ThemortgagedeductionapplicationalsomaybefiledwiththeRecorderintheCountywherethepropertyissituated.Theprevioustaxbillwillfacilitatefiling,butitisnotrequired.
Applicationsfordeductionsagainstrealpropertymustbefiledduringtheyearinwhichthedeductionissoughttobeeffectivefortaxespayableinthefollowingyear.Thefilingdeadlinefordeductionapplicationsfor
mobilehomesandmanufacturedhomesthatarenotassessedasrealpropertyisthetwelvemonthsbeforeMarch31,unlessnotedbelow.
Thedeductionwillappearonthetaxbilltheyearfollowingtheassessmentdate.Foradditionalinformationontheseandotherbenefits,pleaseconsultIndianaCode§§6‐1.1‐12and6‐1.1‐20.9.
Note:TheSalesDisclosureFormisnotanapplicationfortheHomestead,oranyotherrelevantdeductions,foranannuallyassessedmobileormanufacturedhome.
DEDUCTION
(IndianaCode)
MAXIMUMAMOUNT
** ELIGIBILITYREQUIREMENTS
APPLICATIONFORMAND
VERIFICATION(PROOF)
REQUIRED
RESTRICTIONSWHEN
COMBININGWITHOTHER
DEDUCTIONS**
Mortgage
(61.1121)
Thelesserof:
(1)$3,000;
(2)amountof
mortgageorcontract
indebtednesson
assessmentdateof
thatyear;or
(3)onehalf(1/2)of
thetotalassessed
value.
1)PersonmustberesidentofIndiana;
2)Personmustownofbebuyingoncontracttherealpropertyormobileormanufactured
homenotassessedasrealpropertyonthedatetheapplicationisfiled;
3)PropertylocatedinIndiana;
4)Personowesadebtsecuredbyamortgageorrecordedcontractontherealpropertyor
mobileormanufacturedhomenotassessedasrealproperty,whichprovidesthatthe
contractbuyeristopaythepropertytaxes;
5)Withrespecttorealproperty,fileduringtheyearforwhichthepersondesiresto
obtainthededuction,andwithrespecttomobileormanufacturedhomesnotassessed
asrealproperty,fileduringthetwelvemonthsbeforeMarch31ofeachyearforwhich
thedeductionissought(ifmailedthemailingmustbepostmarkedonorbeforethelast
dayforfiling);
6)Contractbuyermustsubmitcopyofmemorandumoftherecordedcontract,containing
alegaldescriptionwiththefirststatementfiledunderthisdeduction.
StateForm43709
Applicationsmaybefiledwith
eithertheAuditororRecorderin
theCountywherethepropertyis
situated.

Note:Anewapplicationmustbe
filedwheneveraloanonreal
estateisrefinanced.
None
INDIANASALESDISCLOSUREFORMINSTRUCTIONS Page8
DEDUCTION
(IndianaCode)
MAXIMUMAMOUNT
** ELIGIBILITYREQUIREMENTS
APPLICATIONFORMAND
VERIFICATION(PROOF)
REQUIRED
RESTRICTIONSWHEN
COMBININGWITHOTHER
DEDUCTIONS**
Over65
(6.1.1129)
$12,480
Note:Ifalljoint
tenantsortenantsin
commonarenotat
least65yearsofage,
thededuction
allowedshallbe
reduced.
1)Individualmustownorbebuyingoncontracttherealpropertyormobileor
manufacturedhomenotassessedasrealpropertyonthedatetheapplicationisfiled;
2)Individualisatleast65byDecember31oftheyearprecedingtheyearinwhichthe
deductionisclaimed;
3)Individualresidesontherealpropertyormobilehomeormanufacturedhome;
4)Combinedadjustedgrossincomenotexceeding$25,000;
5)Individualhasownedtherealpropertyormobilehomeormanufacturedhomeforat
leastone(1)yearbeforeclaimingthededuction;
6)Assessedpropertyvaluenotexceeding$182,430;
7)Surviving,un‐remarriedspouseatleast60yearsofageifdeceasedwas65atthetime
ofdeath;
8)Individualmaynotbedeniedthedeductionbecausetheindividualisabsentfromthe
realpropertyormobilehomeormanufacturedhomewhileinanursinghomeor
hospital.
StateForm43708
InternalRevenueServiceForm
1040forthepreviouscalendar
year.
Thisrequirementincludes
submittingthe1040forthe
applicantandallco‐owners.
PARTIALLY‐Maynotclaim
anydeductionsotherthan
theMortgageandthe
HomesteadDeductions.
Blind
(61.11211;12)
$12,480
1)IndividualisblindasdefinedinIC12‐7‐2‐21(1);
2)Therealpropertyormobileormanufacturedhomeisprincipallyusedandoccupiedby
theindividualastheindividual’sresidence;
3)Individualmustownorbebuyingoncontracttherealpropertyormobileor
manufacturedhomenotassessedasrealpropertyonthedatetheapplicationisfiled;
4)Individual’staxablegrossincomedoesnotexceed$17,000;
5)Withrespecttorealproperty,fileduringtheyearforwhichthepersondesiresto
obtainthededuction,andwithrespecttomobileormanufacturedhomesnotassessed
asrealproperty,fileduringthetwelvemonthsbeforeMarch31ofeachyearforwhich
thedeductionissought(ifmailedthemailingmustbepostmarkedonorbeforethelast
dayforfiling).
StateForm43710
ProofofBlindness
PARTIALLY‐These
deductionsmaybeclaimed
withallotherdeductions
EXCEPTtheOver65
Deduction.
Over65CircuitBreaker
Credit
(61.120.68.5)
Taxliabilityminus
theproductoftaxfor
precedingyear
multipliedby1.02.
1)Individualqualifiedforhomesteadstandarddeductioninprecedingcalendaryearand
qualifiesincurrentyear;
2)Forindividualwhofilessinglereturn,adjustedgrossincomecannotexceed$30,000,
forindividualwhofilesajointreturnwithspouse,adjustedgrossincomecannotexceed
$40,000;
3)Homesteadqualifiesasa“qualifiedhomesteadproperty”forthecalendaryearand
filingrequirementsaremet.(“Qualifiedhomesteadproperty”meanstheindividual
whoowns,ispurchasingthehomesteadoncontractorhasbeneficialinterestinthe
owner,isorwillbeatleast65onorbeforeDecember31ofthecalendaryear
immediatelyprecedingthecalendaryearinwhichthetaxesaredue,andthegross
assessedvalueofthehomesteadontheassessmentdateislessthan$160,000.)
4)Withrespecttorealproperty,fileduringtheyearforwhichthepersondesiresto
obtainthecredit,andwithrespecttomobileormanufacturedhomesnotassessedas
realproperty,fileduringthetwelvemonthsbeforeMarch31ofeachyearforwhichthe
creditissought(ifmailedthemailingmustbepostmarkedonorbeforethelastdayfor
filing);
5)Fileinsamemannerasfor6‐1.1‐12‐9(over65deduction);
6)Appliestotaxesfirstdueandpayablein2009.
StateForm43708
InternalRevenueServiceForm
1040forthepreviouscalendar
yearforapplicantandspouse.
None
INDIANASALESDISCLOSUREFORMINSTRUCTIONS Page9
DEDUCTION
(IndianaCode)
MAXIMUMAMOUNT
** ELIGIBILITYREQUIREMENTS
APPLICATIONFORMAND
VERIFICATION(PROOF)
REQUIRED
RESTRICTIONSWHEN
COMBININGWITHOTHER
DEDUCTIONS**
Disabled
(61.11211;12)
$12,480
1)Anindividualis“disabled”ifheisunabletoengageinanysubstantialgainfulactivityby
reasonofamedicallydeterminablephysicalormentalimpairment,whichcanbe
expectedtoresultindeathorhaslastedorcanbeexpectedtolastforacontinuous
periodofnotlessthan12months;
2)Therealpropertyormobileormanufacturedhomeisprincipallyusedandoccupiedby
theindividualastheindividual’sresidence;
3)Individualmustownorbebuyingoncontracttherealpropertyormobileor
manufacturedhomenotassessedasrealpropertyonthedatetheapplicationisfiled;
4)Individual’staxablegrossincomedoesnotexceed$17,000;
5)Withrespecttorealproperty,fileduringtheyearforwhichthepersondesiresto
obtainthededuction,andwithrespecttomobileormanufacturedhomesnotassessed
asrealproperty,fileduringthetwelvemonthsbeforeMarch31ofeachyearforwhich
thedeductionissought(ifmailedthemailingmustbepostmarkedonorbeforethelast
dayforfiling).
StateForm43710
ProofofDisability:proofthat
applicantiseligibletoreceive
disabilitybenefitsunderthe
federalSocialSecurityAct
constitutesproofforpurposesof
thissection;however,an
individualwithadisabilitynotso
coveredmustbeexaminedbya
physicianunderthesame
standardsasusedbySocial
SecurityAdministration.
PARTIALLY‐These
deductionsmaybeclaimed
withallotherdeductions
EXCEPTtheOver65
Deduction.
DisabledVeteran
(61.11214;15)
$12,480*
1)Individualmustownorbebuyingoncontracttherealpropertyormobileor
manufacturedhomenotassessedasrealpropertyonthedatetheapplicationisfiled;
2)IndividualservedinU.S.militaryserviceforatleast90daysandwashonorably
discharged;
3)Individualiseithertotallydisabledoratleastage62withatleast10%disability;
4)Assessedvalueofindividual’stangiblepropertyisnotgreaterthan$143,160;
5)Withrespecttorealproperty,fileduringtheyearforwhichthepersondesiresto
obtainthededuction,andwithrespecttomobileormanufacturedhomesnotassessed
asrealproperty,fileduringthetwelvemonthsbeforeMarch31ofeachyearforwhich
thedeductionissought(ifmailedthemailingmustbepostmarkedonorbeforethelast
dayforfiling);
6)Survivingspousemayapplyiftheindividualwouldqualifyifalive.
StateForm12662
EitherVAForm20‐5455Code1
InItem#15;PensionCertificate;
AwardofCompensationfromVA
orDOD;orCertificateof
eligibilityfromINDeptofVA.
PARTIALLY‐These
deductionsmaybeclaimed
withallotherdeductions
EXCEPTtheOver65
Deduction.
VeteranwithService
Connected
(61.11213;15)
$24,960*
1)Individualmustownorbebuyingoncontracttherealpropertyormobileor
manufacturedhomenotassessedasrealpropertyonthedatetheapplicationisfiled;
2)IndividualreceivedanhonorabledischargeafterservinginU.S.militaryornavalforces
duringanyofitswars;
3)Individualhasserviceconnecteddisabilityofatleast10%;
4)Withrespecttorealproperty,fileduringtheyearforwhichthepersondesiresto
obtainthededuction,andwithrespecttomobileormanufacturedhomesnotassessed
asrealproperty,fileduringthetwelvemonthsbeforeMarch31ofeachyearforwhich
thedeductionissought(ifmailedthemailingmustbepostmarkedonorbeforethelast
dayforfiling);
5)Survivingspousemayapplyiftheindividualwouldqualifyifalive.
StateForm12662
EitherVAForm20‐5455Code2
InItem#15;PensionCertificate;
AwardofCompensationfromVA
orDOD;orCertificateof
eligibilityfromINDeptofVA.
PARTIALLY‐Thisdeduction
maybeclaimedwithallother
deductionsEXCEPTtheOver
65DeductionandSurviving
SpouseofWWIVeteran
Deduction.
INDIANASALESDISCLOSUREFORMINSTRUCTIONS Page10
DEDUCTION
(IndianaCode)
MAXIMUMAMOUNT
** ELIGIBILITYREQUIREMENTS
APPLICATIONFORMAND
VERIFICATION(PROOF)
REQUIRED
RESTRICTIONSWHEN
COMBININGWITHOTHER
DEDUCTIONS**
VeteranWorldWarI
(61.11217.4)
$18,720*
1)Individualmustownorbebuyingoncontracttherealpropertyormobileor
manufacturedhomenotassessedasrealpropertyonthedatetheapplicationisfiled;
2)IndividualmustberesidentofIndiana;
3)Propertymustbetheveteran’sprincipalresidence;
4)IndividualisaVeteranofWorldWarI;
5)Assessedvalueoftheresidencepropertydoesnotexceed$206,500;
6)Veteranownstherealpropertyormobilehomeormanufacturedhomeforatleastone
yearpriortoclaimingdeduction;
7)Individualmaynotbedeniedthedeductionbecausetheindividualisabsentfromthe
realpropertyormobilehomeormanufacturedhomewhileinanursinghomeor
hospital.
StateForm12662
LetterfromVAorDepartmentof
Defense;orDischarge
Documents.
PARTIALLY‐Thisdeduction
maybeclaimedwithallother
deductionsEXCEPTtheOver
65Deduction.
SurvivingSpouseof
WorldWarIVeteran
(61.11216;17)
$18,720*
1)Survivingspousemustownorbebuyingoncontracttherealpropertyormobileor
manufacturedhomenotassessedasrealpropertyonthedatetheapplicationisfiled;
2)IndividualisspouseofdeceasedpersonwhoservedintheU.S.militarybefore
November12,1918;
3)Deceasedspousereceivedanhonorabledischarge;
4)Withrespecttorealproperty,fileduringtheyearforwhichthepersondesiresto
obtainthededuction,andwithrespecttomobileormanufacturedhomesnotassessed
asrealproperty,fileduringthetwelvemonthsbeforeMarch31ofeachyearforwhich
thedeductionissought(ifmailedthemailingmustbepostmarkedonorbeforethelast
dayforfiling).
StateForm12662
LetterfromVAorDepartmentof
Defense;orDischarge
Documents.
PARTIALLY‐Thisdeduction
maybeclaimedwithallother
deductionsEXCEPTtheOver
65DeductionandVeteran
withServiceConnected
Disability.
*AnyunusedportionafterapplicationtoresidencepropertyappliesnexttopersonalpropertyandlastlyasExciseTaxCreditoneithermotorvehicleexcisetax(IC6‐6‐5‐5)oraircraftlicensetax(IC6‐6‐6.5)
**Thesumofthedeductionsprovidedtoamobilehomeortoamanufacturedhomethatisnotassessedasrealpropertymaynotexceedone‐half(1/2)oftheassessedvalueofthemobilehomeormanufactured
home.(IC6‐1.1‐12‐40.5)
SpecificdeductionclaimformsareavailablefromthecountyauditororontheIndianaDepartmentofLocalGovernmentFinancewebsite:http://www.in.gov/icpr/webfile/formsdiv/2897.htm
.
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Madison County Assessor Sales Disclosure (Indiana)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 20 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document