Homestead_Phillips (3) H. PREPARER I
Preparer of the Sales Disclosure Form Title
Christine Sullivan Loan Processor
1 Company
i Address(number and street,city,state,country,and ZIP Code)
910 W Main St, Boonville IN 47601
I. SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2-Name as appears on c veyance document
'Shay C Phillips �
' Address(number and street) Address(number and street)
11550 S 1300 E
.04...st ,
1 City,State,and ZIP Code City,State,and ZIP Code
Oakland City IN 47660 /C,C� g
Country' Country C
I USA ('0<75
Email Address
best of my knowledge and bt }ss orrect,and complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally j
�Ti e value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. rOp
S' nature of Seller Signature of Seller
1 WE r�
Print a of Seller 1 Date SignedI (mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
L
; Shay C Phillips -a- -t+ S
I 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
Nathan J Phillips
Address(number and street) Address(number and street)
1550S1300E
City,State,and ZIP Code City,State,and ZIP Code
Oakland City IN 47660
Country Country
USA
Email Address
apply for certain deductions.Identify all of those that apply: 1
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary (Q 0 3. Homestead
® O residence?
O O 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 0 5.Wind Power Device
0 C) for this residence?If yes,provide address: 0 0 6. Hydroelectric Power Device
Address(number and street) 0 0 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County - /^�~
S.