HomeMy WebLinkAboutHomestead_Giesler H. PREPARER
Preparer of the Sales Disclosure Form Title
Libby Hinshaw Escrow Assistant
Company
Address(number and street,city,state,country,and ZIP Code) -
520 Main Street,Suite 1, Jasper, Indiana 47546
I. SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Address(number and street) Address(number and street)
City,state,and ZIP Code City,state,and ZIP Code
Country Country
E-mail address Telephone number E-mail address Telephone number
( ) ' ( )
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 parson 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.
Signature of Seller Signature of Seller
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller ! Date signed(mm/dd/yyyy)
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
Dakota T. Giesler F T L
Address(number and street) Address(number and street) 1
903 S Robin Street
City,state,and ZIP Code City,state,and ZIP Code FEB 1 202�
Princeton, Indiana 47670
Country Country rd
apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
ay 1.Will this property be the buyer's primary UKCI 3.Homestead
O residence? 0 Qr 4.Solar Energy Heating or Cooling System
O Id 2.Does the buyer have a homestead to be vacated 0 1W 5.Wind Power Device
for this residence?If yes,provide address: 0 co' 6.Hydroelectric Power Device
Address(number and street) 0 (1K 7.Geothermal Energy Heating or Cooling Device
City,state,and ZIP Code — -- - -- County
%-'n ^\ -`0'-000 3 6 \/ 22
Under penalties of perjury,I hereby certify that 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.(Note:Both spouse's
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
, .
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