HomeMy WebLinkAboutHomestead_McCurry H. PREPARER
Preparer of the Sales Disclosure Form Title '/L
Pamela Partenheimer Mick 11 .l(n-e4
Company
Address(number and street,city,state,country,and ZIP Code)
219 N. Hart St. Princeton, Indiana 47670
I. SELLER(S)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
The Estate of Gayle L. Johnson by Jennifer L. Colbert, Peti
Address(number and street) Address(number and street)
9855 Clearview Drive
,State,and ZIP Code City,State,and ZIP Code
Haubstadt, Indiana 47639 EDY Y Cit
Country Country
United States Cj �6 2�?
_ ( )
inder penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge flfl t.a,jiscorrect,and complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and inten Qpf� value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. �1 On"
Si ature of Seller L ova__
,�v Signature of Seller
ri ed Narr of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
e nifer L°Colbert as Personal RoA
� •a�•�2
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
Robert A. McCurry Elizabeth A. McCurry
Address(number and street) Address(number and street)
607 S. Mill St. 607 S. Mill St.
City,State,and ZIP Code City,State,and ZIP Code
Owensville, Indiana 47665 Owensville, Indiana 47665
Country Country
United States United States
YES NO CONDITION YES NO CONDITION
O 1.Will this property be the buyer's primary 00 3. Homestead
residence? Q O 4. Solar Energy Heating or Cooling System
O 02.Does the buyer have a homestead to be vacated 0 25.Wind Power Device
for this residence? If yes, provide address: 0 QQ 6. Hydroelectric Power Device
Address(number and street) 0 Op 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County ^� _� -0 0- / _ l L dl s� zZ 3 -� .
i