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Homestead_Clem H. PREPARER Preparer of the Sales Disclosure Form Title James G. McDonald III Attorney at Law Company Address(number and street,city,state,country,and ZIP Code) 120 South Maint 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 Clem Family Trust Address(number and street) Address(number and street) 544 South Cathy Drive I City,state,and ZIP Code City,state,and ZIP Code Princeton, In 47670 Country U ! Country best of my knowledge and belief,is tru rrect a om '� required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsg the vagof tr' d real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. % ,,.,. .S�nature Seller / y_� l'"� Signature of Seller ;'.' Printed Name of Seller `— Date sign d(mm/ /yyyy) Printed Name of Seller signeXimm/d /1)/1A,C 7 £ /�.v-► I/ / 7 Z� .2 /J . J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALLT APPLY Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document Dustin B. Clem - _ Mari sa N_ Clom Address(number and street) Address(number and street) 4999 E. 200 N. 4999 E. 200 N. City,state,and ZIP Code City,state,and ZIP Code Princeton, IN 47670 Princeton, IN 47670 Country Country United States United States 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 O 1.Will this property be the buyer's primary (H--- 0 3. Homestead residence? 0 1 '' 4.Solar Energy Heating or Cooling System 2.Does the buyer have a homestead to be vacated 0 5.Wind Power Device for this residence? If yes, provide address: O Cia"" 6.Hydroelectric Power Device Address(number and street) p �y/7.Geothermal Energy Heating or Cooling Device City,state,and ZIP Code County at) �� 1 �l.00 ,OO© 08 0,0 0 19 Page C oNTRAcT