Loading...
Homestead_Nelson H. PREPARER Preparer of the Sales Disclosure Form Title Britany Bradshaw Agent Company Address(number and street,city,state,country,and ZIP Code) 226 W Broadway, Princeton, IN, USA, 47670 I. SELLER(S)/GRANTOR(S) Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document Traci Lantz, Personal Rep of the Estate of Virgil Ray Wildt Address(number and street) Address(number and street) 5975 E 390 N City,state,and ZIP Code City,state,and ZIP Code Francisco, IN 47649 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 f sifies any information required to be provided,commits a Level 5 felony. Signs of Seller Signature of Seller i inted Name of Seller Date•signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/ddlyyyy) Traci Lantz, Persona ep � ,2 ©,2/ J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY n` lJ: Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document : Geoffrey M Nelson Stacy M Nelson Address(number and street) Address(number and street) ro 1894 S Old State Road 65 1894 S Old State Road 65 d City,state,and ZIP Code City,state,and ZIP Code a 1 Princeton, IN 47670 Princeton, IN 47670 ECountry Country = ! USA 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: vl YES NO CONDITION YES NO CONDITION W of 0 3. Homestead o+' �/ 1.Will this property be the buyer's primary �' /� residence? WI 'II O l� 4.Solar Energy Heating or Cooling System � Q 71 � 2.Does the buyer have a homestead to be vacated O f21 5.Wind Power Device Z co t E. O O for this residence?If yes,provide address: .� 0 6. Hydroelectric Power Device - N tx c Address(number and street) O WI7. Geothermal Energy Heating or Cooling DiEi •" C O : U : City,state,and ZIP Code County F 26-06-19-101-000.757-017 X cad . ___._.._.__-___. co i— Page 3 r cd 0