Homestead_Wesner H. PREPARER
Preparer of the Sales Disclosure Form Title
Hunter Crays Closer
Company
Address(number and street,city,state,country,and ZIP Code)
606 Main St Jasper, IN 47546
I. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Richard A. Golik Jeffery J. Pershing
Address(number and street) Address(number and street)
10045 S SR 57 same
City,state,and ZIP Code City,state,and ZIP Code
Elberfeld, IN 47613
Country Country
E-mail address
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 p erty,or omits or falsifies any information required to be provided,commits a Level 5 felo
Sign • re of II i na re of S er
yie,lfg
aiprfnted Name of el e Date signed(mm/dd/yyyy) 'rt1 rife o Iler - __...----' Date signed(mm/ddlyyyy)
Richard A. Golik 12/30/2021 . J ery J. ershing 12/30/2021
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 conveyance document
James L. Wesner
Address(number and street) Address(number and street)
X10045 S. SR 57,
City,state,and ZIP Code City,state,and ZIP Code
Elberfeld, IN, 47613
Country Country
E-mail address
for certain deductions.Identify all of those that apftly:
YES NO CONDITION YEi NO CONDITION 65
,--, 1.Will this property be the buyer's primary Or 3.Homestead _Cif
121 z co il
'---' residence? 0 IQ14/ 4.Solar Energy Heating or Cooling St3 =
cii 0-4
— 2.Does the buyer have a homestead to be vacated 0 016( 5,Wind Power Device z IN)
0 ti.) —I
for this residence'?If yes,provide address: 0 6.Hydroelectric Power Device
Address(number and street) 0 7.Geothermal Energy Heating or Coifn vice
City,state,and ZIP Code County
26-20-32-100-000.887-001 (-)
co