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Homestead_Query •
H..PREPARER
Preparer of the Sales Disclosure Form Title
Samuel C. Drummy Attorney for Seller
Company
Address(number and street,city,state,country,and ZIP Code)
1418 N 1000 W, Linton,Indiana 47441
1. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Jaimie Lynn Hottell,PR for James M.Hottel Estate
Address(nur'nber and street) Address(number and street)
5680 North-1350 West
City,state,-and-ZIP Code City,state,and ZIP Code
Jasonvilie,Indiana 47438
Country Country
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 property,or o or falsifies any Information required to be provided,commits a Level 5 felony.
Signs of es¢r L C.../1Signature of Seller
io
Printed Name of Seller 1 Date s gne( /dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Jaimie Lynn Hottell <70ZZ
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
Anita_Lynn Query FILE Address(number and street) Address(number and street)2980 South`650 East
City,state,and ZIP Code City,state,and ZIP Code
Francisco,Indiana 47649 SEP 0 1 2022 ��
Country Country
E-mail address T7l. >'r r".r'
E-mail address
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 CD 0 3.Homestead
m residence? 0 0 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 la 6.Wind Power Device
0 0 for this residence?If yes,provide address: 0 0 6.Hydroelectric Power Device
Address(number and street) 0 0 7.Geothermal Energy Heating or Cooling Device
City,state,end ZIP Code County \ 2 t,0Q- co to.
3i1-Q Ol\.
a6- 3- q-
3
