Homestead_Glockner (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Daniel A. Moon Attorney
Company
Address(number and street,city,state,country,and ZIP Code)
111 N. Hart Street, Princeton, Indiana 47670 = Gibson County = USA
I. SELLERS)/GRANTER(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Carol A. Blaine
Address(number and street) Address(number and street)
cao E. 5t ti�l,4, 3 . AQE. S _
and City,state, IP Code City,state,and ZIP Code
c ,Y- a,-4r.�L 1 NI L{-1 Ewa
Country Country
USA
E-mail address
( )
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.
Sig,atwe of Seller '�-� Signature of Seller
Z-t-7 ''-" t�Q/' //C_-e.',.c..i-)
Printed Name of Sefler" Date si ne (mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Carol A. Blaine �L //�j,
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFYµ A LY
B�__u__xx���--1_—Name-as-it-appears on conveyance document Buyer 2—Name as it appears on con`j'on. d ume
Joseph M. Glockner Danielle M. Glockner iD
number and str Address(number and street)
402 N. Railroa Street 402 N. Railroad Street MAR p 3 2022
City,state,and ZIP Code City,state,and ZIP Code
Fort Branch, IN 47648 Fort Branch, IN 47648 +�
Country Country /1 2
USA USA GiBSOCOUNTY
YES NO CONDITION NOITION
� O 1.Will this property be the buyer's primary /--
0 3. Homes
residence? 0 (,a �. o ar eating or Cooling System
O R1 2.Does the buyer have a homestead to be vacated 0 (a 5.Wind Power Device
for this residence?If yes, provide address: 0 Gil 6. Hydroelectric Power Device
Address(number and street) 0 Gil 7.Geothermal Energy Heating or Cooling Device
City,state,and ZIP Code County 76
- /49-/3 - ci eP? -4' O/. O f -4.2 4
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete