Homestead_Ingram H. PREPARER -
Preparer of the Sales Disclosure Form Title
Lindsay M. Phelps Searcher
Company
Address(number and street,city,state,country,and ZIP Code)
226 W Broadway Princeton, IN 47670 �����
I. SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Jeffery C. Johnson Cathy M. Johnson DEC 1 0 9071
Address(number and street) Address(number and street)
1203 W 150 N 1203 W 150 N �� ,,�,�
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670 Princeton, IN 47670 GIBBON COUNTY AUDITOR
Country
USA USA
Country
E-mail address
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.A person who knowingly and intentionally falsifies the value of transferred
real property,or omits or falsifies any Information required to be provided,com #s a Level 5 felony.
Sir of Seller (1 Signet epf Sell y�r��y '�s
PF Nam of Seller Date signed(mm/dd/yyyy) Printed Name of Spire Date signed(mm/dd/yyyy)
/4-- q- z ( 1 -t , - �/
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
Micheal A. Ingram Stacey L. Ingram
Address(number and street) Address(number and street)
-'7), P 4.A sic&1 oca ( -1 '9. 7 a, y ,''.+6-e fA 6. q
City,state. -1--(0and ZIP Code City, te,.and ZIP Code
- 1"11-N cwN (0 t`? if,-) C�}. C-1 11 c 0 Y1 11i (t7 i J7
Country Country
N co% C,,rk t M OVI ci)r71..,
C�
ntify all of those that apply:
O YES NO CONDITION YES NO CONDITION
C 3 Q 1.Will this property be the buyer's primary 10 0 3.Homestead
C) Iii residence?
I 2( i 0 fi21 4.Solar Energy Heating or Cooling System
Co
C, O (;d 5.Wind Power Device
m � 2.Does the buyer have a homestead to be vacated ,(1
- for this residence?If yes,provide address:i/. Q 6.Hydroelectric Power Device
rlarl A r s nu b an et) 0 07.Geothermal Energy Heating or Cooling Device
44_
City, t an ZIikCod N +� 26-11-01-100-004.661-027
IJ. Under penalties of perjury,I ereby 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.A person who knowingly and intentionally falsifies the value of