Homestead_Disney�
SALES DISCLOSURE FORM SDF ID:
Don Dowell
� Pnparero/Ne Sales Dtsdosuie Form
Evansville IN 47715
C�ty. Stn[q and Z/P Code
Tltle
Direct Tille Insurance Aaency Inc
co,npany
_
E�mai/
PlFT01C1L P. 1Z lC-f � �FIIC.O4{ P�KIG(o$
Sd er ]- Nome ar opyevrs on conveyance docvment Sel/er 1- Nome as appmrs on wnvryvnce dorumenf
o� W. WA ninry yo� ��t W��ock
Addrcss (NUm6n ond StreetJ Ar�ddress (NUm6er md5treetJ
PQWCE7DA) . (N ��(0�]0 rRte.rGEiqAJ lN �i7ip%Q
C/ry, SmtS ond ZIP Code
' ___ pry,5ta[qandZlPCOde
Under penaldes of perjury, 1 hereby certify that [his Sales Disclosure, to the bes[ of my knowledge and belief, is We, [orrect
and qpmple[/e/�s//F,equired by law, and is prepared in accordance with IC 6-11-5.5, "Real Property Sales Disclosure Act".
(JJ��aFF-f { „ia/ � // iJ i,
�ce g. �a�G�s
]- Name ar ayymrs an convryance dommrn[
i 7
andZfPCode
I�
Signamre
Bvy<r 2� Namr as vppmrs on convryonce dotument
Addrev (Num6er and Street)
and7JP Lode
THE $ALFS OISCIASIIRE FORM MAY BE USED TO APPLY FOR CEATAI.Y OEDIICi70N5 FOR TNIS PROPEAIV. IOENfIFY ALL OF THOSE THAT APPLY.
� ❑ 1. Will [his property be the buyer's primary
residence? Provide mmple[e address of primary
residence, including county:
�Oi W. W4a,voc,�
drezr (NUm6er and Street)
a,Nce�-pN� iN �l767o GtgSON
Clry, Smte LP Code Covnry
❑ � 2. Does the buyer have a homestead in Indiana to be
'vatatedforthisresidence? ifyes,provide
compiete address of residence being vacated,
including county:
Address (Num6erand5treev)
Ciry, Slou ZIPCode Counry
_�� _��/�
,� ❑ 3. Homestead
� � 4. Solar Energy Heating/Cooling System
❑ � 5.4Vind Power Device
❑ Q 6. Hydroelectric Power Device
❑ � 7. Geothermal Energy Heating/Cooling Device
-❑ � B. Is this property a residential rental property?
❑ � 9. Would you like [o receive [ax statements for [his
property via e-mail? (Provide con tact information
6e(ow. Please see instrucdons for mare informadon.
No[ available in all cauntles.)
_ / / I � � I ' I
Under penalties of perjury, 1 herehy cer[ify [hat this Sales Disclosure, to the bes[ of my lmowledge and belief, is true, corred
and comple[e as required by law, and is prepared in actordance with IC 6-1.1-5,5, "Real Property Sales Disclosure Ac[", (Note: .
Spouse info tion, Social Security and Driver's License/Other numbers are not necessary if no Homestead Deduction is
beingfiled.)�� n,
l� I
Sign
n 9gnvmre ofBUyer1/Spaux
l,'
PAnted 1<gal Neme o/Bvyer7/Spouse Sign Date (NM/00/YYVl7
LastSdigiuo(BuyerlDriver's 5[a[e Las[SDigi/sof5ocialSecuntyNumber I LostSdigitsofBUyer1/SpouseDriveYs Smte LnstSD(gics
Llcense/ID/OtherNum6er Number License/ID/O[herNum6er
�
Gibson Couniy Auditor
101 N. Main SUeet
Princeton, IN 47670
�I�EI�
MAY 9 2011
STAiEfORM
iREASLTFA iU0.N TSIw
111f.V.GOVIX\MEYlFIN.1VCEIC6�.1 ]3d.1
Individuals and mar�ied ro�les aze limited m one homesirad scacdard dcdnction. As ;he rtceipt of �his deduction becomes
morc beneficial, lhere is more incentivc Itw� n�er for tromatcad tnud. Homcstead Geud cauus highcr tax bills for all; thcrcfo¢,
Hk:A 1344-?009 mquircs tupa�crs wiro recertx ihc homestcad standard deducuan to rerify [hat [hey art eligiblc ro rcccnc the
brncfil and to prrnide additiwal idrnlifi�ng information nccessary b allmr county ga�emmrnt lo bensr moviwr ho:natpd
filings. This informacion will be kept confidemial and can onty bc acccsud by auc6oriud wunry of5cials. The Deparvnem af
_ C.'�.�.y •
v r�
6 GIBSON COUNTY A TOR
Anthony W Disney
409 W Warnock St
PRINCETON IN 47670-1259
���I�I��i�l��ll��"I'I�������'I�II��"�I�'��II�II'����I"��II'�I�
I II�I �I I
Taxpaver Name
Disney, Anthony W
II�I I��IIII�II Il��lln
Location Address
409 W Wamock
Princeron IN 47670
�QII�II�I�II I�III
State Parcel Number Leqal Description
26-12-06-303-000.093-028�P.�KViEW TanCT #1 6 2 70 .67 AC
: ..
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.
Addrtss (¢umbcr end strect ciry, stau, md Z[P codc)
iriry Numbcr (lazt 5
�
as propeny eddress
'LlPcode)..,. - .--.'_.� . . . _—'.�'Suueaspmperry�address— . _ .
Other (pleau 5pccify in Pan 4 below)
undersigned certifies, under penalty of perjury, that the above and foregoing infortna[ion is We and cortect and that he or she is eligible to
✓e the homestead standazd deduction on this property. Each undersigned also understands that, by claiming additional homestead deducrions
✓fully, he or she may be liable for back ta�ces and substanual fmancial penalties. � �
� 1 Si Date
�
� )