HomeMy WebLinkAboutHomestead_Tucker (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Leon C. Stone President
Company
Address(number and street,city,state,country,and ZIP Code)
226 West Broadway Street, Princeton, IN 47670
I. SELLER(S)IGRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Amanda Smith,Personal Representative of the Estate of Terri D.Smith
Address(number and street) Address(number and stP IL
E 1
5628 S 125 W
City,state,and ZIP Code City,state,and ZIP Code
Fort Branch, IN 47648 JUL j
Country Country a 2022 v�
United States of America
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.
Sig ature of Sell r Signature of Seller
rt �
nnted Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Amanda Smith `1 I c7PZ Z
J. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
( )
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 O 0 3. Homestead
Cl residence? 0 f 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 Cl5.Wind Power Device
O O for this residence? If yes, provide address: 0 C) 6.Hydroelectric Power Device
Address(number and street) 0 O 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
—1Z01 —2,0tt— 002 02 -OzB
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
Page 3 of 5
it
i
NO CONDITION
Page 2 of 5
t