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Homestead_ Smith Jr H. PREPARER Preparer of the Sales Disclosure Form Title Daphne Kramer Paralegal Company Address(number and street,city,state,country,and ZIP Code) 226 W Broadway St., Princeton, IN 47670 I. SELLERS)/GRANTOR(S) t i Seller 1—Name as It appears on conveyance document Seller 2—Name as appears on conve:>n'e u t John Brown Address(number and street) Address(number and street) 609 N Ford St / City,state,and ZIP Code City,state,and ZIP Code 4Q �� Princeton, IN 47670 v � - Country Country USA SA G/eSO _ E-mail address best of my knowledge and belief,is true,c omplete as required by law,and is prepared In accordance with IC 6-1.1-5.5.A person who knowingly and Intentionally falsifies the a of transferred real property,or om or falsifies any Information required to be provided,commits a Level 5 felony. Signature ell .,., Signature of Seller rinted Name of Seller Date signed(mm/dd/yyyy) - Printed Name of Seller Date signed,(mm/ddlyyyy) John Brown .ei )1 1 0Li/a u;}y 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 George Thomas Smith,Jr. Brittany Gilford Address(number and street) Address(number and street) 229 S Seminary St 229 S Seminary St City,state,and ZIP Code City,state,and ZIP Code Princeton, IN 47670 Princeton, IN 47670 Country Country E-mail address YES NO CONDITION YES NO CONDITION O O 1.Will this property be the buyer's primary O 0 3.Homestead residence? 0 O 4.Solar Energy Heating or Cooling System 2.Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device for this residence?If yes,provide address: O p 6.Hydroelectric Power Device Address(number and street) 0 O 7.Geothermal Energy Heating or Cooling Device City,state,ZIP code,and county Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete Page 3 of 5 r'- h