Homestead_Nelson (6) H. PREPARER
Preparer of the Sales Disclosure Form Title
Pamela Partenheimer Mick Attorney
Company
Address(number and street.city.state, country. and ZIP Code)
219 N Hart St, PO Box 13, Princeton, IN 47670
I. SELLER(S)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appear n eyance document
VINOD C. GUPTA
Address(number and street) Address(number and street) 4,47,,17962 FOXBOUROUGH LANE 3, \\
City.state.and ZIP Code City,state,and ZIP Code 4(jG �v /
BOCA RATON, FL 33496
Country - Country . . . �13 \\
(AC),-k d S}-6. 4 S oi,e, _
of my knowledge and bell** orrect and complete as
re re y a d' pr p ed in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally fQ4tfies the value of transferred
r I ope r o is o f sifies any information required to be provided,commits a Level 5 felony.
ignature er Signature of Seller
P n ame f S Date signed(mm/dd/yyyy) Printed Name of Seller ' Date signed(mm/dd/yyyy)
OD C. GUPTA
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
MICHAEL NELSON ELIZABETH NELSON
Address(number and street) Address(number and street)
421 N HART ST 421 N HART ST
City.state.and ZIP Code City,state,and ZIP Code
PRINCETON IN 47670 PRINCETON IN 47670
•
Country Country
GIBSON GIBSON
YES NO CONDITION YES NO CONDITION
O O 1.Will this property be the buyer's primary O O 3. Homestead
residence'? 0 O 4. Solar Energy Heating or Cooling System
O O 2. Does the buyer have a homestead to be vacated O O 5.W nd Power Device
for this residence'? If yes, provide address: 0 O 6. Hydroelectric Power Device
Address(number and street) CI p 7.Geothermal Energy Heating or Cooling Device
City.state,ZIP code, and county
— P--o�— )o1"{--cx0_ 1K`f —of .
Under penalties of perjury,I he by certify that this Sales Disclosure,to the best of my knowledge andef,is true,correct and complete
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