Homestead_Simmons (9) - H. PREPARER
_ __ k
Preparer of the Sales Disclosure Form 1 Title ry V
1 Ladonna Thompson I Closer 1.
g Company -
i Address(number and street,city,state,country,and ZIP Code) ii
E 465 Sheridan Rd., Noblesville, IN 46060 'r
I.SELLER(S)/GRANTOR(S)
' Seller 1—Name as it appears on conveyance document rn ��t ) Seller 2—Name as appears on conve Re c ent 4
Jordan Simmons
Address(number and street) Address(number and street)
t)------1:
1509 Cottonwood Drive doe ['
':; City,state,and ZIP Code r T� } City,state,and ZIP Code /v
Princeton, IN 47670 , CO32
United States • , United States i Country Country G/eSCNCpv�2.'1� / t
E-mail address '
�roq
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred t'
ii real property,or orpits or falsifies any information required to be provided,commits a Level 5 felony-
` Signature,of Seller I Signature of Seller il
l
s Prieted/Name of Seller ' Date signed(mm/dd/yyyy) i Printed Name of Seller I� Date signed{mm/ddtyyyy)
J. BuYER(S}IGRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY 1
6 rim.-.:.-..--.. _ -•-r....:^zn[anrr-� �r_—..r "".,i
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document
r Jordan Simmons s Emily Simmons
Address(number and street) ? Address(number and street) li
r
1509 Cottonwood Drive ° 1509 Cottonwood Drive g
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670 Princeton,IN 47670
i Country Country
United States United States
E-mail address
— YES, NO CONDITION
i 1.Will this property be the buyers primary /cE El 3. Homestead R.
i ❑ residence? ❑ ..41 4.Solar Energy Heating or Cooling System
a i ❑ ..E' 5.Wind Power Device 2. Does the buyer have a homestead to be vacated � $
t. ❑ for this residence? If yes, provide address: _ ❑ 4 6. Hydroelectric Power Device g
4 Address(number and street) ❑ � 7. Geothermal Energy Heating or Cooling Device fi
a City,state,and ZIP code,and county L�L ` _ ( 4�! ��( O'L _ ,
p�Q 12 C7
t Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
as required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of r
t; transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Note;Both spouse's
�
Page 3 1,- ,
ram"
clzs- u: