Homestead_Hayes III 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 Main Street, Princeton, Indiana 47670
I. SELLER(S)/GRANTER(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
DYLAN LEE DAVIS
Address(number and street) Address(number and street)
2229 South 950 East
City,state,and ZIP Code City,state,and ZIP Code
Oakland City, IN 47660
Country Country
( )
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.
Signatu Seller Signature of Seller
Printed Nal2eirCtTIer Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
DYLAN LEE DAVIS 1;?,-•//3rZ0Z(
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY AT APPLY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on con yan d ume t
DON WTTJ,TAM HAVER ITT
Address(number and street) Address(number and street) D�
1007 S Sromg Street C 2 . -40:0
City,state,and ZIP Code City,state,and ZIP Codtb
Princeton, IN 47670 /os'p,`r ?"s/
Country Country 001f r/
USA y G^��"", ��
E-mail address
( r/
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
_/Q 1.Will this property be the buyer's primary (3,V Ir. 3. Homestead
i 4+ residence? 0 lam'" 4.Solar Energy Heating or Cooling System
ci, Does the buyer have a homestead to be vacated 0 5.Wind Power Device
0 w' for this residence? If yes,provide address: 0 l " 6. Hydroelectric Power Device
Address(number and street) (] 7.Geothermal Energy Heating or Cooling Device
City,state,and ZIP Code County O"LO r\ -D aQ fLk 00 -D ^^2