HomeMy WebLinkAboutHomestead_Messick •
H. PREPARER
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r 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.SELLER(S)/GRANTOR(S) . .
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Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Steven Thomas Miller Linda K. Miller
Address(number and street) Address(number and street)
8710 E 360 S 8710 E 360 S
City,state,and ZIP Code City,state,and ZIP Code
Oakland City, IN 47660 Oakland City, IN 47660
Country Country
USA 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.
Sign tur of Seller ` Si na e of Seller
.,PO m of ej�k l,A.0 Date signed(mm/dd/yyyy) " to Name of Seller ,0 Date signed mm/dd/
9 ( yyyy)
Steven Thomas Miller 01/21/2021 Lind K. Miller 01/21/2021
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
Keith A. Messick Cindy Messick
Address(number and street) Address(number and street)
1897 S Lakewood Circle 1897 S Lakewood Circle
City,state,and ZIP Code City,state,and ZIP Code
Francisco, IN 47649 Francisco, IN 47649
Country Country
USA USA
E-mail address
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YES NO CONDITION YES NO CONDITION ao
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0 O 1.Will this property be the buyer's primary 0 0 3.Homestead z a, iii
Greside ce? 0 RI 4.Solar Energy Heating or Cooling System o N IH
Does the buyer have a homestead to be vacated 0 t� 5.Wind Power Device z N L-1
for this residence?If yes,provide address: N tsj
O 0 RI 6.Hydroelectric Power Device D
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IA lbws(number and street) ���� 0 (21 7.Geothermal Energy Heating or Cooling D�
,� (-1'T ram' ,D eri a-&L&--
O Ci e,and ZIP Code unoil 73
O A-00_ 1 sr-D I 4--- /_ r -aj ` 26-13-34-100-001.675-006 0
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