Homestead_Tooley H. PREPARER
Preparer of the Sales Disclosure Form Title
Patti Kolb Closing Manager
Company
Address(number and street,city,state,country,and ZIP Code)
226 W Broadway St., Princeton, IN 47670
I. SELLERS)/GRANTOR(S) •
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Sue E. Tooley
Address(number and street) Address(number and street)
439 S. Jackson St.
City,state,and ZIP Code City,state,and ZIP Code
Oakland City, IN 47660
Country Country
USA
E-mail address
( )
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
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Signature of Seller Signature of Seller
Printe ame of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Sue E. Tooley 0 j -67-aoa I 0
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLYp-NC c_
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document =
Brian D. Tooley Zella D. Tooley o 0 H
Address(number and street) Address(number and street) z N L.t
-
7608 E. State Rd 64 7608 E State Rd 64 ; Cri
City,state,and ZIP Code City,state,and ZIP Code d
Francisco, IN 47649 Francisco, IN 47649
Country Country
USA
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply:
et YES NO CONDITION YE NO CONDITION
o 1.Will this property be the buyer's primary CI 3.Homestead
N a residence?
0 (if 4.Solar Energy Heating or Cooling System
Tr
rn 2.Does the buyer have a homestead to be vacated 0 Q1 5.Wind Power Device
o a for this residence?If yes,provide address: 0 g 6.Hydroelectric Power Device
c `d ss(number and street) A 0 WI 7.Geothermal Energy Heating or Cooling Device
,-I Ci , t�e,an�dNZIP Code oounnty
1 �V621 r)& 9 g] f,YJ 26-14-19-102-001.094-007
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