HomeMy WebLinkAboutHomestead_Smith (8) k �. _ •
H. PREPARER
Preparer of the Sales Disclosure Form Title
Jason M. Spindler Attorney i
Company
I
Address(number and street,city,state.country,and ZIP Code) i
1112 N. Main Street, Princeton, Indiana 47670 � —�� _�.
I. SELLERS)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears onj■(c ocu ,T
Kevin L. Smith l�J ■■y//1
Address(number end street) Address(number and street)
I4gLf5 old 54I / /'
Cayy,stale.and ZIP Code J / City,state,and ZIP Code MAR 1 8 2022
77
Country,541 _ Country t/1_ ,1.QLi a. .1%.4�'4✓
�711''}�r G�t�g(<g.Gp/N ClUNTv AUDITOR
E-mail address
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.
Siggetum of Sel:r r Signature of Seller
Pri ted Name of Seller Date$igned(mm/dd/yyyy) Printed Name of Seller l Date signed(mm/dd/yyyy)
ne-i-ify Sin,-/ex , 3 /-5/a2-
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY i
-
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document
Elisha A. Smith I
Address(number and street) Address(number and street)
113 S. Damosa Drive i
City,state,and ZIP Cade City.state,and ZIP Code E
Haubstadt,Indiana 47639
Country Country
USA
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
Q 1.Will this property be the buyer's primary el/ 0 3.Homestead
residence? Q G3' 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 1 0 GY 5.Wind Power Device
0 to for this residence?IT yes,provide address:
Q Qv' 6.Hydroelectric Power Device
Address(number and street) Q CJ' 7.Geothermal Energy Heating or Cooling Device
City,state,and ZIP Code County 6-fj S-36-ko 3-poO-OLc-0 Oct
3