HomeMy WebLinkAboutHomestead_Adler (10) 1 H. PREPARER
i Preparer of the Sales Disclosure Form Title
1 Jenn Young Mortgage Processor
Company
Address(number and street,city,state,country, and ZIP Code)
910 Main Street, Boonville, IN 47601
I. SELLER(S)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Jerrod D Clutter
Address(number and street) Address(number and street)
2-0 oI Go...4,v_ef 0 rdt 4ApC
City,State,and ZIP Code City,State,and ZIP Code
e PA,tt l-i d!: t"�(t M7.11-c PI Country Country
N. L 1-
r4h1lhJtL
Email Address
best of myknowledge andrb f is true,correct,and contp ete as
Under penalties
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and iraigeo I if es the'value of transferred
real property,or omits r falsifies any information required to be provided,commits a Level 5 felony. COUNT :-r.
Signal re Sell Signature of Seller YA/j0;"
Print Nery te
of Seller Date Signed( m/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
\ 14,0-PG 1) (-101 7. .1- 6-rA
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
Katye E Adler
Address(number and street) Address(number and street)
5494 E 1300 S
City,State,and ZIP Code City,State,and ZIP Code
Elberfeld, IN 47613
Country Country
USA
deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
O O 1.Will this property be the buyer's primary 00 3. Homestead
residence? 0 O 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 CI 5.Wind Power Device
O 2 for this residence? If yes, provide address: O 17 6. Hydroelectric Power Device
Address(number and street) O 17 7. Geothermal Energy Heating or Cooling Device
City,Slate,and ZIP Code County
a6-013-l3 -40--00/. o117-oaZit
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct,and co e
4.
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