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Homestead_Fougnies (4) INDIANA SALES DISCLOSURE FORM SDF ID: Page 2 D.PREPARR _: ' : — J. Robert nkle Attorney Preparer of Sales Disclosure Form Title PO Box 13, 219 N. Hart Street Hall, Partenheimer& Kinkle Address(Number and Street) Company Princeton, IN 47670 812-386-0050 City,State,and ZIP Code Telephone Number E-mail Joe Fniignies Jill R Fougnies Seller I-Name as appears on conveyance document Seller 2-Name as appears on conveyance document 612 F Indian Street 379 S 5th Ave Apt 26 Address(Number and Street) Address(Number and Street) Princeton IN 47670 Princeton IN 47670 Under penalties of perjury,I 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": � — ��- � �Q/ a(C,rG SL , zJ A—nature of Seller ' Sign of Seller U - ,loP Fougnies 02/25/2013 Jill R Fougnies 02/c S /2013 Printed Name ofSeller Shin Date(MM/DD/YYYI) Printed Name of Seller Sign Date(MM/DD/Y7111 ;F:BUYER(S)/GRANTEE(S):APPLICATION,FOR-PROPERTY-TAX DEDUCTIONS-IDENTIFY ALL'ITEMS THAT APPLY Joseph K. Fougnies Buyer I-Name as appears on conveyance document Buyer 2-Name as appears on conveyance document 612 E, Indiana Street Address(Number and Street) Address(Number and Street) Princeton, IN 47670 Telephone Number E-mail THE SALES DISCLOSURE FORM MAY BE USED TO APPLY FOR CERTAIN DEDUCTIONS FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY. YES NO CONDITION YES NO CONDITION 0 ❑ 1.Will this property be the buyer's primary 0 ❑ 3. Homestead residence? Provide complete address of primary ❑ 0 4. Solar Energy Heating/Cooling System residence,including county: ❑ ri 612E Indiana Street 5.Wind Power Device Address(Number and Street) ❑ 0 6. Hydroelectric Power Device Princeton, IN 47670 Gibson ❑ 0 7. Geothermal Energy Heating/Cooling Device City.State ZIP Code County ❑ 0 2.Does the buyer have a homestead in Indiana to be ❑ 0 $ 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.) Address(Number and Street) ab-)a-)`6 a0a Kl1 Joseph K.Fougnies q 36 6 as City,State ZIP Code County Primary property owner contact name E-mail Gibson County Auditor 101 N Main PRINCETON IN 47670 � 3549 Joe Fougnies 612 E Indiana St PRINCETON IN 47670-2756 TIlA54RfA W0.4:FIA IndiciduaL. anJ marriN rouple. arc IimiteJ to nnc home9caJ �andaN d�luc�ioa As thr rtteip� M ihis dadunion becmree • merc beneficial. thrrr i. morc incrntne dun ner (or hom�teaJ fnud Iloma�eaJ f`aud caa� hi�her �a� bills (or all: thercfore. ' HEA 134:-2009 reqvim uxpa.cn �ho recci.c the hqnes�caJ nandard dnfunion b rerilj' Iha� �hey are eli:iNe lo rcecne ihc • bene0l and ro prtr�ide :ukliiional iUrntiP)'inc fnfumiation riecesvn' ro allw' county gmemmml tu Nt¢r monirw honxs�eaJ �ilin��. This inlnmu�ion wiil be Aa�w conti�IeNial anA can nnl�� F.� xerx<ed M1y nuthorized rnuniy n0icialz_'fhe Ik�wnnrem nf Local Gm'cmmrnt FinaM'< ��fll uw thfs info�mmion N crw:e 0.vls �hm will help cqmn' offidaLs eliminai< hom<srcml haud. .�� �� � I�I��II���I�II��I�„III�����I�II���I�I�I��II�����II��I�I��II�I Taxpaver Yame Fougnies, Jill R / Joe State Parcel Number Prapert�• Addre�s 61? L Indiana lkince�on I\ 47670 Leeal Descriotion 2612-18-202-001.930.028 073-o193POOSS.4�D 3a3 \ �• � Oxner I� I I First Middle � fasi � �� n1eS �g Add�s (numbcr nnd sffcc[, city, smtc, and ZIP codc) - —�--- -- -- --� Snme as pmperty odd`¢i -- ---- -- l� � l�an� %�r cnc�-�o✓� //1/ �{-t l0 7� $ Spoa;e First � Middlc . Last `j o �, �occ n � es Mailing Addrev (t.umber and svccl city, slate, and "LIP coJe) ('V1 Same:u p�opmy addreas (9�a �� l�c�iCLna.. �'inCe�on �N '� �71� �o . . , Each undersigned cenifies, undzr penalty of perjury. [ha� the abovr and foreeoing infortnation is true and comct and that he or she is elieible to receive the homestead siandard deduction on this propeny. Each undzrsicned al;o understands that, by claiming additional homestead deductions unlawfully, he or she may be liable for back taxes and substantial financial penalties. Owner I Siimatu({ , /� � Datc ' . �� � ,� ,