Homestead_Fox (2) 13 /I .
INDIANA SALES DISCLOSURE FORM SDF ID: Page 2
D.PREPARER
Jerry D.Stilwell Attorney at Law
/.F Preparer of the Sales Disclosure Form Tide
U.
` 02 N.Prince Street Bamberger,Foreman,Oswald&Hahn,LLP
Address(Number and Street) Company
Princeton,IN 47670 812-386-6482
City.Stare,and ZIP Code Telephone Number E-mail
E.SELLER(S)/GRANTOR(S) •
Eveyn Lankford
Seller 1-Name as appears on conveyance document Seller 2-Name as appears on conveyance document
310 N.5th Avenue
Address(Number and Street) Address(Number and Street)
Princeton,IN 47670
City,State,and ZIP Code Ciry,State,and ZIP Code
Telephone Number E-mail Telephone Number E-mail
Under penalties of perjury,1 hereby certify that 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".
X , 4.4"(
Signature of e , // Signature of Seller
Evelyn Lankford 0 7/c'J/2 O/1
Printed Name of Seller Sian Date NM/OD/MO Printed Name ofSeller Sian Date(MM/DD/YYYYI
F• R RANTEE(S)-APPLICATION FOR PROPERTY TA EDUCTIONS1DEKIFY ALL ITEMS THAT APPLY
Princeton,IN 47670
0
THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS':•• . • ' s •LL OF THOSE THAT APPLY.
YES NO CONDITION YES NO CONDITION
❑ TA 1.Will this property be the buyer's primary / ❑ 3.Homestea I
residence? Provide complete address of ph• ary IN . ; . -rgy Heating/Cooling System
residence,including county: ❑
S.Wind Power Device
Address(Number and Street) ❑ TA 6.Hydroelectric Power Device
City,State ZIP Code County ❑ TA ?.Geothermal Energy Heating/Cooling Device
❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ 0 8.Is this property a residential rental property?
vacated for this residence? If yes,provide ❑ 0 9.Would you like to receive tax statements for this
complete address of residence being vacated, property via e-mail?(Provide contact information
including county: below. Please see instructions for more information.
Not available in all counties.) Q 1 (/
Address(Number and Street) Z 6-i/-/a -,o3- Ooa / V 7 1 .. oa (y
City State ZIP Code County
Primary property owner contact name E-mail
� ;-'CCAIM'FOR'HOMESTEAD'PROPERT.Y..:TAX-=,:..- ' -
' -CREDIT/STANDARD DEDUCTION-==== �_=_-� �= � �
/ SIaIC Fam 5773 (R6 / M3) " �' ° "' ' '
-" ' `Prestntetl by the Department of Locai Govemmenl Finance "' -' '' '"' ' '
� INSTRUCTIONSr$ee�revcrsdsideioriilinq'irishiiclinna:'"'-'� �° '?��- p
. ,���--.�i..'. ._
�Have a beneficial interest in the,en6ty�that;s Iiabie for ihe property:taxes on the�
: �: .. . ... . . _ .. _ . . .
If buying on contrad, Fee Simple owner's name �
.n nc� -�
' Recorders ofice whera contraG is recorded _ . , , , . � � �
na
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FORM YEAR
HC10
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- �Sy^ T 2
on the tsl day o( March, 20_
ert�Tac Credit is hereby daimed:
or is buying under a wntraU.
Rewrd number � Page
- - '- � - Tamship ' ' " ' - ' ' � � Tming tlistrict (ciry, town, fownship) �'
. ... . . . ,_auy�" , .. . , . . c ,.. ,, � . �
beE�7 r /, /� (J� Lagal descri ' Is the O�operty in question_
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� (���u ❑RealDroperty ❑MObileHOmo(I.C.6f./-n
uUon of Ihe residential s W Uure or Na land not exce ing one (7 � arre Nat immedi t ty surrounds ihat structure is used lo D��uce income, Aescribe the use antl portion
operty uWized m protluce irkome.
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Gibson County Auditor
101 N. Main SVeet
Princeton, IN 47670
FILED
APR 7 2011
= C.'J.n�
GIBSON�COUNTY AUDITOR
346
nAh
IFFwSLRFR LOKN TSI�
o Indi�iduals anJ married muplu are limired to one homesuad. standarJ deductioa As the rereipt of ihis dcdislion bemmcs
mare brncficial, �Acre is more ivcentivc than c�zr for Fwmatcad (raud. Homes�rad (mud auces Nghn �u bills for all; �hcrc(orc,
HEA 13A4-2009 mquires taxpa�xrs wlw recei�r thc homestcad scandard deducuan to �<rify ihac [6ey arc cligiblc w rcccn< �Ire
benefil and to prm�ide additional idrnufi�ing informntion ncccssary to ellau� county gwmunent io bcucr monimr homcstcad
filinns. ltus intormation will bc Lept confidrn[ial and can onty be aceessed by audwrized counry ofTicials. 7Le Departrt�rnt of.
Laal Grnxmmrnt Fimnce w�ill ust this information to creatt tools Ihat w�ll hely munry� officials elimi�ute homes[ead fraud.
�' 1'
John R Fox Iil - - .�
208 N Fifth AVE
PRINCETON IN 47670-1022
�II�II��I��"�I11'll���l�l����l����ll��lllll'�II����I�IIII����I��
Taxpaver Name .
Fox, John Raymond / Jennifer Renee
IIII�I�III��II) �II II III �II�I �III ul0llll��ll�
State Parcel Number
Location Address
208 N Sth AVE "
PrincetonlN 47670
I� II�I �II �I II I� II I IIO ull� II�I �II II� IIII
Legal Description
26-11-12-103-002.879-028 /TOWER HGTS 776
✓
A
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.
�
undersigned certi6es, under penalty of pequry, that the above and foregoing information is we and correct and tha[ he or she is eligible ro
+e the homestead standazd deducrion on this property. Each undersigned also undecstands that, by claiming additional homestead deducrions
�fully, he or she may be liable for back taxes and substantial financial penalties.
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