Homestead_Smithhart (2) H. PREPARER
Prep er of the Sales Disclosure Form Title
L "ah,fsson
Company E-mail address
Address(number and street,city,state, country,and ZIP Code)
c0 qq S- Wash; s-( , Oakland C;;4 TA) 474,&O _
I. SELLER(S)/GRANTOR(S) J
Sehy►er 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
/c my 3-o 1T1 n So/1 _ -
Address(,lumber and street) I Address(number and street)
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City,state,and ZIP ode City,state,and ZIP Code
Ofx <<U1 C I l YAI 1 147toly 6
Coustryo Country
E-mail address
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.
Sign re of Se ,/ Signature of Seller
Pr nted N e of S er Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
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J. BOYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Bu��yJ�err',1--�iName as it appears" la o�In conveyance document Buyer 2-Name as it appears on conveyance entt
Address(numpand street) } Address(number and street) 144,4b
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City,state,and ZIP Code City,state,and ZIP Code S
0o14(� cay - r"J M'Lri c�ry Country G/es 2?Zr��1
to sores oq,< 2
E-mail address
apply for certain deductions.Identify all of those thatrar
YES NO CONDITION YES NO CONDITION
O 1.Will this property be the buyer's primary 1i 0 3. Homestead
residence? 0 421/ 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 5.Wind Power Device
for this residence? If yes,provide address: 0 lg 6.Hydroelectric Power Device
Address(number and street) 0 (V 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county C717(O -, '?i0 - 1- .0 lei//yyi D�1- N'
3 of 5
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