HomeMy WebLinkAboutHomestead_Elliott (5) H. PREPARER
Preparer of the Sales Disclosure Form Title
Pamela Partenheimer Mick Attorney
Company
Address(number and street,city,state,country,and ZIP Code)
219 N. Hart Street, 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
John M. Dunn Patricia Dunn
Address(number and street) Address(number and street)
555 S. Persimmon Lane 555 S. Persimmon Lane
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670 Princeton, IN 47670
Country Country
Gibson County, USA Gibson County, 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 Lev felony.
Si atur of Seller pi ig of Seller
)4/
ted Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
John M. Dunn 12/07/2021 Patricia Dunn 12/07/2021
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 co e e cum n
David Larney Elliott
Address(number and street) Address(number and street)
1798 SR 65 N
City,state,and ZIP Code City,state,and ZIP Code DEC 13 2021
Princeton, IN 47670
Country Country Wie.eld a-,
Gibson County, USA GIBSON COUNTY AUDITOR
( )
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
FA 0 1.Will this property be the buyer's primary WI 0 3. Homestead
residence? 0 WI 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 WI 5,Wind Power Device
0 WI for this residence? If yes, provide address: 0 &I 6. Hydroelectric Power Device
Address(number and street) 0 WI 7. Geothermal Energy Heating or Cooling Device
City,state,and ZIP Code County
l-a- 1 L-*Zoo-000- 520 -02- - .
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