HomeMy WebLinkAboutHomestead_Page (3) 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. SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
April D. Mann f/k/a April D. Shaw
Address(number and street) Address(number and street)
101 S Weber Drive
City,state,and ZIP Code City,state,and ZIP Code
Haubstadt, IN 47639
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.
Si ribture of Seller Signature of Seller
ice;`
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
April D. Mann f/k/a April D. Shaw 02/10/ o -i
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
Jacob Page
Address(number and street) Address(number and street)
120 Olive Drive
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670
Country Country
USA
E-mail address
( )
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
YES NO CONDITION YES NO CONDITION 07
cn
0 0 1.Will this property be the buyer's primary g 0 3. Homestead z
residence?
0 g 4.Solar Energy Heating or Cooling System H
O g 2.Does the buyer have a homestead to be vacated 0 2 5.Wind Power Device N N
\
for this residence?If yes,provide address: 0 g 6.Hydroelectric Power Device
Address(number and street) 0 g 7.Geothermal Energy Heating or Coolin o ice
City,state,and ZIP Code County x
26-12-07-404-002.470-028 W
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