Homestead_Noles •
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
Dana Annette Rice
Address(number and�trnt)�� Address(number and street)
City, tate,and ZIP Code • City,state,and ZIP Code
% Ol1c0AJ I\14936
Country
Country
USA
( )
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
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Dana Annette Rice 02/05/2021
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
James L. Noles
Address(number and street) p Address(number and street)
/ 3 0 i a SL'''0.-4,oe9e 1 ‹, Z.
City,state,and ZIP Code City,state,and ZIP Code
i , ZG/ b 4 ) 1 LI7j1
Country Country
USA
E-mail address
for certain deductions.Identify all of those that apply,.
YES NO CONDITION YES NO CONDITION W
cn
VI O 1.Will this property be the buyer's primary g 0 3.Homestead z m
cri
residence? o H
0 (,� 4.Solar Energy Heating or Cooling Sys
2.Does the buyer have a homestead to be vacated 0 1 5.Wind Power Device N r
0 for this residence?If yes,provide address: N
O � li.Hydroelectric Power Device
Address(number and street)
O fig 7.Geothermal Energy Heating or Coolig vice
0
City,state,and ZIP Code County