Homestead_Johnson (18)[NDIANA
Brvceann Cutsinoer
Preporer of rhe Salu Dltdoture Form
226 W. Broadwav
Address (Number ond Sveet)
Princeton.IN 47670
Ciry. 5mrq and Z/P Cade
�E. SELLE
Selfer ]- Name os appears on tonveyunre documen!
A36 E Oak St.
Addrea (A'umber and Strre[J
Tltle
Broadwav Title.
Seller 2- Name as appmrs an conveyvnce dotument
�
Under penaldes of perjury, I hereby certify [hat this Sales Disclosure, to the best of my Irnowledge and
and comple[e r quired by law, and is prepared in accordance �+n 6-1.1-S.S, "Re�al Pr(o� e ale:
,L7J �/ti-�— �-w�-r.�.c.._\ � �
Signamre o(Sel/er 5ignamre o(Seller
Richard J Koss ��"�d��� Pamela L Koss ���
F. BUYER(Sl/GRANTEE(S) - pPPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL
as appmn am m�veyonce
Address (NUmber and Svee[J
Otwell IN 47564
CIry.Smre, and ZIPCOde
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Buyer 2- Name as appeors on cam•e}vnre document
Address (Number and Street)
City, 5[are, and ZIP Lo(dJe
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THE SALES DISCLOSURE FORM M1L1Y BE USED TO APPLY FOR CERTAIN DEDUCf10N5 FOR THIS PROPERTY. IDENTIFY ALL OF THOSE THAT APPLY.
0 ❑ 1. Will [his property be the buyer's primary
residence? Provide comple[e address of primary
residence, including county:
876 E Oak St
Addre.s (Number and SveetJ
Princeton IN 47670 Gibson
City, Smte ZIP Code County
� ❑ 2. Does [he buyer have a homestead in Indiana to be
vacated for this residence? If yes, provide
complete address of residence being vacated,
including county:
1431 N CR 825 E
Addres (Number and Stree[)
Otwell, IN 47564 Pike
Ciry, State ZIP Code Covnry
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4. Solar Energy Heatlng/Cooling
5. Wind Power Device
6. Hydroelectric Power Device
7. Geothermal Energy Heating/(
S. Is [his property a residential r
9. Would you like to receive tax :
property via e-mail? (Provide <
6elow. Please see instrucdons�
�� _ p� _ 3od -oo
owner tonmct nam[
Under penalties of perjury, l hereby cerdfy that this Sales Disclosure, to the best of my kno�vledge and
and complete as required by law, and is prepared in accordance with IC 6-1.1-S.S, "Real Property Sales
Spouse informadon, Social Security and Drivers License/Other numbers are not necessary if no Home:
being filed ' C n
��/1i1 Q�i�1 � , �J.o-l�-w1c�^
Signomreo/ er7 / SignaNreo(Bu r2 Spouse
( — /O — /S Marv C lohncnn
LastSdigi[so%Buyer2/SpouseDriver's Smte
License/ID/OtherNum6er Num6er License/ID/OtherNumber
E�mall
is true, correct
sure Ac[".
��
�Q
�line Device
tal property?
irements For this
�tact information
more information.
.3oy-o
, is true, correct
�sure Act". (Note:
Deduction is
Digits of Social5ecurity