Homestead_Henson 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. SELLERS)/GRANTER(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Household Thoughts, LLC by Brian Ellis
Address(number and street) Address(number and street)
I *AN®._ S US /,tfr4"l
City,state anr+71P rode City,state,and ZIP Code
f - 155 tibt1 -743
ountry / Country
USA
E-mail address
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(mmldd/yyyy)
Brian Ellis, Managing Member
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
Caleb Henson
Address(number and street) Address(number and street)
4384 W CR 300 N
City,state,and ZIP Code City,state,and ZIP Code
Petersburg, IN 47567
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: n
YES NO CONDITION YES NO CONDITION t
O 1.Will this property be the buyer's primary ELI 0 3. Homestead z 71, Fx
residence? o WI 4.Solar Energy Heating or Cooling System 8 N
1 2. Does the buyer have a homestead to be vacated 0 Il 5.Wind Power Device N ti
for this residence? If yes, provide address: 0 6.Hydroelectric Power Device a s
Address(number and street)
p WI 7.Geothermal Energy Heating or Cooling Debi
o 17
City,state,and ZIP Code County 26-13-19-201-000.263-005