HomeMy WebLinkAboutHomestead_WorthingtonPREPARER
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rAddras(Numbcand5bee[) Company
Lafavette. IN .47905
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Addras (NUmber and Svee[)
Lafavettelndiana 47905
NIA
- Name as appmrs w mnveyvnre documrrt
Addras (Num6a and Sveet)
[iry, Smtq aneZlPCode
Under pena�t'fes of per'u , 1 hereby cerdfy that this Sales Disclosure, to the bes[ of my knowledge and belief, is true, correct
and c f�p �[e as r uired by a, d is prepared in accordance wi[h IC 6-1.1•5.5, "Real Property Sales Disclosure Act".
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Si a reofSAlu Signan�reof5eller
PI"vmfelName SfL� Mfe NN D R'v�tedName Shcc S7 nOble MM O
F.BUYER GRANTEE -APPLICATTON.FORPROPERTYTAXDEDUCffONS-IDENTIFYALLITEMSTHATAPPLY
James Hunter �c�cpl, Hunter
Baya I- Namem appmrson rmve�av¢drcvmm[ �jer2- Nmoem appmrs m mrve�mredo�omt
1104 S Race St 1104 S Race St
Addras (Num6aand Sbee[) Addras (NvmbrrandSbeetJ
Princeton.IN.47670 Princeton IN 47670
, NIA
77iE SALES DISO.OSURE FORM MAY BE USm TO APPLY FOR CERTAIN DEDUCfI0N5 FOR THIS PROPEftTY. IDE.YfIFY ALL OF THOSE'1'FIAT APPLY.
Q � 1. Will this property be the buyer's primary
residence? Providecompleteaddressofprimary
residence, including county:
Addras (NUm ber arsd Stree[)
Princeton.Indiana.47670 Gibson
City,SmleLPCade Cwnry
� ❑� 2. Does the buyer have a homestead in Indiana to be
vaca[ed for this residence? Ifyes, provide
complete address of residence being vaw[ed,
induding county:
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❑ ❑�
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3. Homestead
5. Wind Power Device
6. Hydroelectric Power Device
�9
.System (�190
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t�0
7. Geothermal Energy Heaang/Cooling Device
8. Is (his property a residential renfal proper[y?
9. Would you like [n receive tax statements for this
�erty via e-mail? (Provide contact in�ormation
ow. Please see instrucGOns for more information.
availa6le in all coundes)
Addras(NvmberandSCeR) �/.�j yI� [��/�
Liry,Smle7lPCade �l��/'I�` I�_�O�^�OI. Tf1o'O��
Counry
Pn'marypmpertyowneraonmRname Emad
Under penaltles of perjury, I hereby certify that this Sales Disclosure, [o the best of my knowledge and belief, is true, correct
and comple[e as required by law, and is prepared in accordance wi[h IC 6-11-5.5, "Real Property Sales Disclosure Ad". (Note:
Spouse information, Social Security and Driver's License/Other numbers are not necessary if no Homes[ead Deduction is
being filed.)
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