Homestead_Moody 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)/GRANTER(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Tiffney R.Alexander
Address(number and street) Address(number and street)
214 N Race St.
City,state,and ZIP Code City,state,and ZIP Code
Haubstadt, IN 47639
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 prop n'ty, r omi's or fats' i s any information required to be provided,commits a Level 5 felony.
S' eta"' f S Ile Signature of Seller
' e eller Date signed mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Tiffney . lexander (�y 1 �ivia P
J. BUYER(S)/GRANTEE(S)—APPLICATION F R PROPERTY TAX DEDUCTIONS—IDE A L Bil
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
Brandon K. Moody APR 2 5 2072
Address(number and street) Address(number and street)
102 S Race St. //2 � ailir
� .naJ
City,state,and ZIP Code City,state,and ZIP Code /'
Haubstadt, IN 47639 GIBBON COUNTY AUDIT
Country Country
OR
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
1.Will this property be the buyer's primary 0 0 3. Homestead
O O residence? 0 O 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
O O for this residence? If yes,provide address: O O 6.Hydroelectric Power Device
Address(number and street) 0 O 7. Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county D,6_19 -31 -Sot -o O'o. CDR-II- 00q
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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