Homestead_Young (16) H. PREPARER
Preparer of the Sales Disclosure Form Title
Pamela Partenheimer Mick Attorney
Company
Address(number and street,city,state,country,and ZIP Code)
219 N. Hart St., P. O. Box 13, Princeton, IN 47670
I. SELLER(S)/GRANTOR(S) 1 TT
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears pnny ce dci tut�eLrll ■
Terry Wallace L L
Address(number and street) Address(number and street)
4361 W 1000 S APR 2 5 71122
City,state,and ZIP Code City,state,and ZIP Code
Fort Branch, IN 47648 � ikdAi,a)
Country Countryeth ITOR
Gibson -USA GIBBON COUNTY AUD
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 I ifies any information required to be provided,commits a Level 5 felony.
Signs of Sel er Signature of Seller
Printed N of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Terry Ilace 04/20/2022
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
Dustin D.Young
Address(number and street) Address(number and street)
1416S250W
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670
Country [
E-mail address Telephone number
( ) ( )
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
O O 1.Will this property be the buyer's primary CIO 3. Homestead
residence? O 0 4.Solar Energy Heating or Cooling System
O CI for
Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
for this residence?If yes,provide address: 0 O 6.Hydroelectric Power Device
Address(number and street) 0 0 7.Geothermal Energy Heating or Cooling Device
City,state.ZIP code,and county
of 5
copy