HomeMy WebLinkAboutHomestead_Seabolt 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 St, PO Box 13, 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
LaSheila M. Miskell-Frederick
Address(number and street) Address(number and street)
1421 Jefferson Ave
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670
Country Country
Gibson County, USA
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 falsities any information required to be provided,commits a Level 5 felony.
Sig(r ture f Sell r �} rn,,,�n A„, /}0- Z. . Signature of Seller
q� e1 � ' •` ' 44- - . 741 Date signed(mm/dd/yyyy)
Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller g
LaSheila M. Miskell-Frederick
apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES--- N CQN TIDI_ ON 1
1.Will this property be the buyer's primary �' 1 0 3. Homestead-
0
O residence? 0 O 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 CI 5.Wind Power Device
O Cl for this residence?If yes,provide address: 0 O 6. Hydroelectric Power Device
Address(number and street) 0 O 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county A.4, -/?. - 67- .o 3-,o o/. Sb 7 - 0
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