Homestead_Blanton H. PREPARER
Preparer of the Sales Disclosure Form Title
Patti Kolb Closing Manager
Company
Address(number and street,city,state, country,and ZIP Code)
226 W Broadway St., Princeton, IN 47670
I. SELLER(S)IGRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Gayle Winkler Russell Feagley
Address(number and street) Address(number and street)
6303 W. Old Princeton Rd. 6053 E 390 N
City,state,and ZIP Code City,state,and ZIP Code
Owensville, IN 47665 Francisco, IN 47649
Country Country
USA USA
E-mail address Telephone number 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 operty,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Sig re of Seller •
real
of Seller
Printed Name of Seller Date signed(mm/dd/yyyy) rinted Nam- . Senn 4 Date signed(mm/dd/yyyy)
Gayle Winkler 6,2- /7--c7c7'‹77 ---. Russell Feagley ,--.2-/
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
Bailey M. Blanton
Address(number and street) Address(number and street) FILED
1095 N Shiloh Church Rd.
City,state,and ZIP Code City,state,and ZIP Code
Hazleton, IN 47640 FEB 2 3 2022
Country Country
USA 47hec4a.il a ,i/k,,,, ._.
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
1.Will this property be the buyer's primary 0 0 3. Homestead
C) 0 residence? 0 C) 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 0 5.Wind Power Device
0 0 for this residence?If yes, provide address: 0 0 6. Hydroelectric Power Device
Address(number and street) 0 0 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
(1-VI -0 1 -4.04- 000. 53 3-0-az
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