Homestead_VanMatre H. PREPARER
Preparer of the Sales Disclosure Form Title
Daphne Kramer Paralegal
Company
Address(number and street,city,state,country,and ZIP Code)
226 W Broadway, Princeton, IN 47670 FIL F,
I. SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance documen
Robert R. Fulling 1 8 2022
Address(number and street) Address(number and street)
334 S Jackson St. 7
City,state,and ZIP Code City,state,and ZIP Code�7'; chg1( �li. JiY2tz`k.:,:aJ
Oakland City, IN 47660 GIBSON COUNTY AUDITOR
Country Country
USA
E-mail address
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.
Signature of Seller Signature of Seller
—"—
Printed Name of Seller !- Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Robert R. Fulling y-/3.-
zz
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
Ceth VanMatre
Address(number and street) Address(number and street)
9546 E. Main Street
City,state,and ZIP Code City,state,and ZIP Code
Mackey, IN 47654
Country Country
USA
E-mail address
for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
O 1.Will this property be the buyer's primary CIO 3. Homestead
residence? 0 f 4.Solar Energy Heating or Cooling System
o 2.Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
for this residence?If yes,provide address: O O 6.Hydroelectric Power Device
Address(number and street) 0 IN 7.Geothermal Energy Heating or Cooling Device
City,state.ZIP code,and county
6_ly- t'8-kn3 -moo 1 _ 211- 00-7
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
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