Homestead_Koch (2) 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, PO Box 13, Princeton, IN 47670
I. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conve document
Joedy J.Greenwell ILE')
Address(number and street) Address(number and street)
2139 N Carithers Road
City,state,and ZIP Code City,state,and ZIP Code Sep
Princeton, IN 47670 1 42022
Country Country
best of my knowledge and belief,is true,correct and€Ooftplete as
required by law,and Is •repared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred
real pr•• rty,or omi > • aisifies any information required to be provided,commits a Level 5 felony.
Signa of Sell- ' Signature of Seller
-
p: : G- -liar Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
• Greenwell 09/14/2022
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
Shawn Michael Koch, Jr.
Address(number and street) Address(number and street)
2087 N.Carithers Road
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670
Country Country
GIBSON
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 O 0 3.Homestead
O O residence? O O 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 0 5.Wind Power Device
O O for this residence?If yes,provide address: O f 6.Hydroelectric Power Device
Address(number and street) 0 O 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county V 0-O - 33 30o-oW _ gat - `�-t
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
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