Homestead_Tedrow III H. PREPARER
Preparer of the Sales Disclosure Form Title
Daphne Kramer Paralegal
Company
LED
Address(number and street,city,state,country,and ZIP Code)
226 W Broadway St., Princeton, IN 47670
I. SELLERS)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on convM0e io3'm28124
Rita M. Nash Kathryn M. Liden
Address(number and street) Address(number and street)
315 Chestnut 104 SW Mill .
City,state,and ZIP Code City,state,and ZIP Code (t2t4cl,.41-12 &. ; `d)
Mt. Carmel, IL 62863 Patoka, IN 47666 GIBSON COUNTY AUDITOR
Country Country
USA USA
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,commits a Leval 5 felony.
Sig Lure of Seller . ature of eller
. in . t'V1 L
nnted Name of Seller Date signed(mm/dd/yyyy) Printed Name of Sellet3 Date signed(mm/ddlyyyy)
Rita M. Nash Kathryn M. Liden
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
Arthur Tedrow, Ill Mende Tedrow
Address(number and street) Address(number and street)
502 Garfield Ave 502 Garfield Ave
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670 Princeton, IN 47670
Country Country
USA USA
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply:
O YES NO CONDITION YES NO CONDITION
1
O O 1.Will this property be the buyer's primary O 0 3.Homestead
Po residence? ❑ p 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
r.) I:) ❑ for this residence?If yes,provide address: 0 O 6.Hydroelectric Power Device
O
0 Address(number and street) 0 O 7.Geothermal Energy Heating or Cooling Device
r 502 Garfield Ave
ri) City,state,ZIP code,and county
Princeton, IN 47670 26-01-1-14 -30S - 00a 7- o2.,0
Po Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,Is true,correct and complete
q , ic w . 5 pefi
transasreferreduired rebyallaw propertyand is,orprepared omits orn falsifiesac ordance any informaith ICti6on1.1 require.5.Ad torson be providedwhoknowingly,commitsand a Level 5 felony.Intentionallyfalsi(Note:esthe Both spouvalueofse's
rJ Information,SSN/Driver's Licens D/Other Number is necessary if a Homestead Deduction Is being file
Page 3 of 5
f 1 nv „ P} k
., ? ;