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SDFID:
Repare�a/rhe Sala Disdosure Form TiUe
� 716 S. Main Sireet
Addr¢v(Numberand5trtt[) Lompany
Princeton IN 47670
E-mail
Seller 1� Nome as apptars on conveyanre dacvmm[ Sellu 2- Name as appears om m�veyanre docummt
8055 C 600 W
Addras (NvmW and Street) Addr� (Number and Strn[)
Owencvilla IN 47665
Ciry, Smre, and ZIPCade Ciry, Smt¢ and ZIPCOde
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E-mail Trle honeNVmber E�mail
Under penalties of perjury, 1 hereby certify that this Sales Disdosure, to the bes[ of my knowledge and belief, is [rue, correct
and c�plete as reqq�red by law, and is prepared in accordante with IC 6-1.1-5.5, "Real Property Sales Disclosure Act".
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TAX,DE
Buyer 1 - Name as
' Ciry,Smre,andLPCadt
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THE SALES DISCLOSURE FORM MAV BE OSED TO APPLY FOR CERTAI,Y DHDUCI'IONS FOR THIS
Q � 1. l4�i11 this property be [he buyer's primary
residence? Provide comple[e address of prima
residence, induding county:
F07 W FmPrcnn 4t�P t
Addras(Numberand5trx!)
Princeton IN 47670 Gibson
Ciry. Smte ZIPCade Counry
� Q 2. Does the buyer have a homestead in Indiana [o be
vacated for [his residence? If yes, provide
comple[e address of residence being vaca[ed,
induding counry:
(NUmberandSVttQ
[iry,sm[eZIP[ode Counry
Signomre o(Seller
Pnn[ed Name o(Seller
)CTIONS-IDENTIFY ALL ITEMS �THAT .
Buyrr 2� Name as appean on conveyance dorvment
Address (NUmber and Strre[)
[iry, Smre, md Z1P tode
Te/ephone Num6er
PROPER .IOET�TIFY�O OSETH.ITAPPLY.
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VFS KO COI:DITIOY
❑J ❑ 3. Homes[ea .
f-�ILI._as.�+�finergy Heabng/Cooling System
� Q S. Wind Power Device
❑ ❑✓ 6. Hydroelectric Power Device
❑ ❑✓ 7. Geo[hermal Energy Hea[ing/Cooling Device �
� Q✓ B. Is [his property a residential rental property?
� ❑✓ . Would you like [o receive tax statemen[s for this
�����property via e-mail? (Provide contoct information
below. Please see instruc[ions for more information.
Not availa6le in alI roun[ies.)
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Under penal[ies of perjury, t hereby cer[ify [hat this Sales Disclosure, to the bes[ oFmy knowledge and belief, is true, correct
and complete as required by law, and is prepared in accordance with IC 6d.1-5.5, "Real Property Sales Disdosure Ad". (Note:
Spouse informa[ion, Social Security and Driver's License/Other numbers are no[ necessary if no Homestead Deduction is
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J�1FA1 1�. n�ti'�
Pdnted Legal Name o/Bvye I
Number
Signamre oJBvya2/Spovse
Pnn[MLegalNomeo(Bvyer2/Spovse
Sign Date (xA/00/YY1�7
LastSdigi[sojBuyer2/SpouseDriver's Smte LastSDigiaoj5odalSecunry
Number License/!D/OtherNum6er ;
Gibson Caunty Audilor
101 N. Main Street
Princeton,IN 47670
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iRFASI�'RkA f00.M lS-IA
I0.E5L1U6mBY
Individuals and manicd mupla are limired m ane homestead standud deduc[ion. :1s the receipt of �his daiuction 6ecomes
more brneficial, iherc is more intcntive tlw, ever for homestead Gaud. Homestead (rzud rauses higAer ux bills for all; thercfore,
HEA 1344-?009 rtquires ta<pa�rrs wiro eecenz the homestead standard deducrion to �xrifi� ehat ehey am eligi6le to receiee the
bmefi� and to prmidc additional idrntifiing infortnation nccessar�� to allaw tmmty gm'emmcel lo bener monitor hamesiead
filings.'Ittis infortnation w�ll be kept tonfidrntial and can onW be aceesud by au[horized counrv officials. The Lhparvnmt of
I.ocal Gm�emmrnt Fi�vnce uill use this informa[ion m creau tools ehat will helo counry ofTic¢Is elimi�um homestead frzud
David L Fithian
8055 S 600 W
OWENSVI�LE IN 47665-9309
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Taxpaver Name
Fithian, David L
III�I �I I I�
Location Address
602 W Emerson
Princeton IN 47670
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State Parcel Number Leqal Description
26-12-07-103-003.186-028 e�alR ENLG 8
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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.
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Nailing Addless (¢umber end svecl. ciry, sta[c, and ZIP code)
lso� �. £�n�erSo�� S� � P c����e��,�.A�. y �
iocial Sccuriry \�ber Qast 5 dipts) Drivels LiccnseJState ID Number (last 5 diAa)
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ipo� Fiat Middb
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�lailing Address (Number and street ciry, statc. and 7.IP cade) ` �`� �� � Q� ��
c� oa c� � £me � �
iocial Securiry Number (lut 5 digiss) Drivers License/State ID Number (lazt 5 digia)
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s�� � P��,�r aaare�s
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Other (plcau specify in Pan 4 bclow)
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O[her (plcau spcci(y in Pan 4 bclow)
undersigned certifies, under penalty of perjury, that the above and foregoing infortnation is vue and correct and that he or she is eligible to
re the homestead standard deducrion on this property. Each undersigned also undecstands that, by claiming addirional homestead deducrions
vfully, he or s6e may be liable for back [axes and substantial fmancial penalties.
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late TNephone
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