HomeMy WebLinkAboutHomestead_Case[NDIANA•SALES DISCLOSURE FORM SDF ID: Pa e 2
hD?;P,REPARER?? � � 1�."'v� �'xs�"�in��x'.c-�Ttr`�:^�—.�`�-`...�a.'i�i!'S'`aa°=�!�*,-5..�-�"5'�z€"".,°`�',r��S��'����#'�„*':}� :a.Y`.+s-�'�;�s�ii.s Tnm -a�_�'`s"��".�:.s� �'�
,�s fi• .- ....- �
Rav M. Drulev Attomev No. 4759-26
%eparer o(Ne Sala D'udosvrc Farm AUe
�i05 N. Church Street. P.O. Box 746 Law Office of Rav Drulev
Addras (Numf er and Street) Lompany
Fort Branch. IN 47648 (
iE^�SELL'ER' S".GRt1NTOR �S ������,+.'.?�..�--� a1..�.•.�.��:M�`�.v�"�'.���?�.f',�' a,'�"��'�,*'Sl�= �"1��._.'�3',s3� w�s :.���t%>;'�'��'� x� �-� e_3*_-a't
Dalr A. Shawgo Chriatina A Shawgo
Selfer 7- Name as opp¢ars on tonveyvnce dxumen[ Se11er2 - Name as appears m mnveyance documen[
205 S Willard ?OS S Willard
Address (Numbe� and Stree[J Addrest (NUmber and StrtttJ
Fort Branch IN 47648 Fnrt Rraneh IN 4764R
City,SmtG mdLPCade Ciry, Smtq ond7JPCode
Under penalties of perjury, l hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and c/om�pleteB as reqwre by law, and is prepared in accordance with C 6-1.1-5.5, "Re�afl Pr�op erty Sales Disclosure Act".
�/� l�f � �� _ ���� /x `Uf..-ctca'f.�?
Signawre a/Seller 5{gnature of5eller �d
nala a Shawpo `f'2/ —�/ Chrictina A �hawqo `� a����
Pri lfer Si �DOI¢ HH n RintedNameo Sefler S nDate NN D
`-"BU;YER9',G TEES�;��AP.BCICATIONiF.OR�P.ROPERTYtiTAX�DEDUCTIONS�IDENTIF;Y��AliL?ITEMS'_s '° � `'��'�"
, , THATAP.P,GYs��'�*�..��•-;�'s.•
K II
- ameasappmrsomm�veyvnredocvment Buyer2-Nameasapprarsomm�ve}nnredoavmmt
526 W State Street
Addror (h'umberand SveeQ Addras (Number and 5tree[)
Princeton IN 47670
'iry, Smte. and ZIP Code Ciry, Sfo[e, and LP lode
���
E-mall Tele honeNumber E-mail
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOF CERTAIN DEDUCf10Y5 FOR THIS PROPERTY. LL OF TNOSE TNAT APPLY.
YFS NO COtiDRiOY YES NO COYDRION
Q � 1. Will [his proper[y be the buyer's primary ✓Q ❑ 3. Homeste
residence? Provide complete address o rima , o ar Energy Heaang/Cooling System
residence, including county: �
� 09 W M I��rty street ❑ ❑✓ 5. Wind Power Device
Addras(Numberand5treet) ❑ Q✓ 6. Hydroelectric Pawer Device
Pnnceton IN 47670 Gibson _ � Q 7, Geothermal Energy Hea[ing/Cooling Device
Ciry,5mte7J ode County
� �2. Does the buyer have a homestead in Indiana to be � ❑� , 8� �s this property a residential renral property?
� vaca[ed for this residence? If yes, provide ❑ ❑✓ 9. Would you like to receive tax sWtements for Chis
comple[e address of residence being vacated, property via e-mail? (Provide rontact informodon
including county: 6elow. Please see instruccions%r more injormadon.
No[ availa6le in al! caundes)
Addrer(NumberandStreeQ !J/ �/� � /�'�%� �[O� - aQ/ 3�3 _6d�'
�/7 (O V / V
Ciry.SmreZIPCode Caunry
%imorypropertyawner tonmtt name E-mail
Under penalties of perjury, I hereby certi(y tha[ this Sales Disclosure, to the best of my knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5, "Real Property Sales Disclosure Act". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homes[ead Deduction is
being filed.)
`�% �/ ,f� 'c�
Signamre of8uyerl (� '7 SgnaNre o(Bvyer2/Spouse
� n r��co 1�� I'_ LO �I
Las[Sdigi[sa(Buyer2/SpouseDrrver's Sta[e Last50igiGSOfSocial5ecunry
License/ID/O[herNumber Num6er License/(D/OtherNumber
�
Gibson Counry Audiror
101 N. Main Sheet
Princeton, IN 47670
FILED
_ APR 10 2012
= C.`J.n4�.y
v \1
GIBSON COUNTY AUDITOR
826
:'rnrz raa.� s:w�n�tvai in:nsuux �ocv rsi.a
.�rnm'sm'�veamrtnor.vi�r..��s.}.� rrt��xuuenurn¢nvnzivclaia:ucmu��m.rt���.�'�rct�.��•+.�
Indicidual� �nJ marric�l muple� arr Iimi�N io one hnnxsmaJ >�an4rd Jnluaiun. � �F.< reeeiry o( �hi> dNuo�ion fxzumre
mon bcncticiaL �hcrc is r.rorc iccrnti�c tlun cccr lirt hom:,t�nd Gaud. tlumr�_nd GaW cavus iichcr m� bills (or cIL dn�r(or,.
HF:A 13J3-'_OW requirs uxpa.m uin rrc:ivc :he fwmeveaJ vandarJ dedunion to �eriPo tF.ac they are elioiblr �o recei�z �Ae
b.ncfit a�ul �o pnridc aJtliiiva9 idcmifyim_ irli�mution n.:c�on� �o allrnr mumy� gm'cmrtrcnc to Lv¢r nxmi�or homc+nd
filing�. �Ihi intomuiion xill be keq confiJ�rynial and tan only Iw aYr:xJ br autFwrizN counn� of8cul.. The Depanmen o(
Lixal Gu.crr,r,nm Fnancc wiil u-c thi. informa�ion iu cn.7tc trcric ;ry�i xill hclp ronnrc nlTiciaL. ciimim�c Mmcacad frauJ.
. � � � �
Taxoaver Name Location Address
Shawgo, Dale A/Christina A
Kelty D Case
320 W Mulberry St
PRINCETON IN 47670-2344
ild���lllil�lli�lllliil��i����i���i�i��lli��i�l I�ii���l�ll�i���i
320 W MULBERRY ST
PRINCETON IN 47670
Ilululllu IIIullul II IIWII�IIIIWIIIIIWIUII�II�
State Parcel Number Leqal Description
26-12-07-303-001.323-028 HALLS2ND ENLG 3oPT
�II lu II o
This form MUST be returned to County Auditor's office.
Please do NOT send this form back with your tax payment to the county treasurer.
I l / � {'IIRI
�� LL
n�
p Addmss (number and suea, city, statt, and "LIP code)
Securin' Numbcr (lut i di_ics)
�
Addrss (�urc�er xnd s'mt, ciry', sWte. and'l.IP code)
`��
Number (latl i diKits) I��'«s Liccnsc/State ID �umber
� ��Swe
Middle
5 digis)
A.Sc
Sameaspropenyaddross
O�her (plrue speciCy ir. Part 4 below')
� Same as propeny add:ess
sp:afy ir. Pan i bclox)
undersiened certifies, under penalty of perjury, that the above and foregoing information is true nnd cortect und that he or she is eligible to
; e ihe homatcad standartl deduction on this property. Each undersigned also underslands that, by claiming additional homestead deductions
✓fully, he or she may be liable for bach tases and substantial financial penaliies.
0
��/ � %�
( )