Homestead_Goforthi�oi,��.� s,u.es nisc�osuee roia��i sor u� zs-zoos-i0000sz r�� z
�D. PREPARER � - . . . . � — - . ; ,.. � .. .. ., . . .. ,�:.,, : . _ � . ..
SHERRIE WEIL ACCUTITLE, LLC 0.ERK
Pre�xrrer nJlhr.Sult� Di.�tLrnirc Fum� Tid:
3820 OAK HI�L RD ACCUTITLE, LLC
Adrlress (A7nnhrr und 5'IrrrU
�
Cib'. Stnre. anJ %/P Cixle Teltph�urc .\'umlHrr E-mail
E. SELLER(S)/GIiA\TOR(Sj � . . - � ' . . . � � � ' . .. - • ... . . � . : ;,.� q.
JOHN W GOFORTH JR WANDA LEE GOFORTH
S� llrr -,tlnrn..,�..n�i...�r� nn ��.,in�rr.iu�, dorumrm Sel1. i' -,Vem: �i� up�a✓n ��n � uuri.umir Jwvm� ru
Soo Mo,�s4�a�U (�vc. SAME.
AAdrr..� � nc....6..,...d nc,.....,� .I JJms.s L\'urnher mrJ Srrcerl
�.o�oVv�O.% 1J2QG(� VA
�ib'.Stn�.onJ%IPGxI. � Cint37�ur.nuJ/.IPCnJv
�
F.'-mnil TelephoneA'muhrr E-woil
nder penaltics o(perjun�. 1 hereby certifi� that �his Sales Disclusure, to the best uf m}• knu�vledge and belie(. is true, correct vnd
omplete as rcyuired br law, and is prep:ired in accordanee �ri�h IC 6-I.1-55, "Real Prnperh• Sales Disclosurc Act".
S EE p� qcH�
Signnnnerf&�llei� Sigu�im: ol5�dler
Yrin�ev/.\'omrnf.A•l/rr S�viDntepll.i!/pU9'i'1')1 Vrinrttl,tlnmrol.tieller SiguUme(:111//UL)M'Ylj
�F.�.BUI'ER(S)/GR.�1\TEE(5) c APPLICATIO:\ FOR DED,UCTIONS:�1\D C1tEDITS -_IDE\TIFI'.ALL ITEp1S.TH4T�:IPPLY�=��•• '
I JOHN K GOFORTH STACI A GOFORTH
Bin•er -,1'��m<• m ap(H�m:� uu : unre�vwr. d.n umom Bumr -,\'�nu. u+ upyears nn ouun_ruure J�x��nxrru
2645 325W. SAME
.Wdre..s /A'umbrr nuJ Srrrep .4dd�rsa p\'unrbrr mid Sher/I
PRINCETON, IN 47670
Cin•. Slate. m�J ZlN Cndr Cin'. SYNe. �nd Z/P Codc
( L)_ _
TelepGoneA'mrrArr fi�nini! Tr/cphm�eASmilt�r . E-rrrai/
1'lIE ti,�LhS DItiCLOSIIItF; FOR\I DI.\\' Illi UtiF,il l'U APPLI' FUH CEIt'I',\I� UEDUCflO?'S FOK'f1115 PROPEN'I'\'. IDE\"flF1',U.L Uh"I'IIOtiE'1'IL�'P
r I. �1'ill this pmpc« y bc thc bupers primary residcncc? Prueidc � 3. liumcsicad
complctc adJress of priman• residrncc, including cuunnc �:{ S�lar I:ncrgy Hca�int�Cooling Systcm
364S 325W r?. \VinJ Pu�rcf Dcvlcc
.aJd,��•„ (\'um6ivoudSlrrrU r 6. Fh�drocicciric Powcr Dcricc
PRINCETON. IN 47670 Gibson
r i. Gco�hcrmal [ncrgq Hcatine%Coolin, Dcvicc �
Cdp. Slmr. nnd %!P CaJe Cmum� �
r 2. Docs thc btq�cr ha��c a homcstcad to bc vacatcd for this r S. Is this propert�� a residcntinl rcntal property?
residrncc? If qcs, pm��idc complcic address of residcncc v.icatine.
including county: /J/J
d✓Jrc�>(A'umhernuJSvicetl l/�(/ ///Q ��OQ �C/OO. O/el+V ' C/O°'C
Cin•. STale. nnJ7JP CoJe CuuMi
n er pena ues o per�un'. �ere c ce u c t at t Sa es isc osure. to � ie >esl u �m� �no�r e ge an e ie , is true, correct an
� complete • rcquired bv I• �r, and 'ti epa d' cordance �rith IC 6-1.1-i.i, "Keal Prupert�• Sales Disclosure Act".
�`/,� ✓
�gnnh�rr q(Bm'r�� Sienunn-c o(Fur. �
/�i✓ ,� 0 2 - -
Yrnrtrd��'uruenlH�p�rr .SignDatr/,tldl'OD!YI'1l"1 Priwrd;\'ernc.�(Hm'er SignDortiAfl//Ub/)'Y)"Y)
STATE FOR.\151569 ({UI&10) - TRFASURER FOR.�1 TS-IA
MPRO\'FD BY SfATE BOARD OF ACCOl7\T5. 30D9 PRESCRIBFD BY THE OEPARTME\T OFl.O('AL CA�'EM\¢\T fTA\CE IC61.1-'3-8.1
, / , ' / / / . 1 1 � , 1 � , �
Indi��iduals and married couples are limited to one homestead standard deductiou. As the Peceipt of this
•duction becomes more beneficial, there is more incenti��e than ever for homestead fraud. Homestead fraud
causes higher tax bills for all; therefore, HEA 1344-2009 requires taxpayers who receive the homestead
standard deduction to verify that they are eligible to receive the benefit and to provide additional identify�ing
information uecessary to allow county government to better monitor homestead Tlings. This information
will be kept confidential and can only be accessed by authorized county officials. The Department of Local
Government Finance will use this information to create tools that will help count}� officials eliminate
homestead fraud.
Taxnarer \ame
John K Gafonh
Complete and retum ro:
o� �
Jo�n
Al2i11lp AOCIB55 (nVnCH NW WBB� i
Soaai
Last
Each undersigned certifies, under penalty of perjury, that the above and foregoing information is true and cortect and that he or she i; eligible to receive the
homestead standard deduIXion on this property. Each undersigned also understands that, by claimin9 additional homestead deductions unlavrfulry, he or
she may be liable for back tazes and substantial (nancial penalties.
Ovmar l Sgrutwe Da[a TeleWwne
-��-�z
(