Homestead_Norman H. PREPARER
Preparer of the Sales Disclosure Form Title
Gabriella VanAlstine Escrow Assistant
Company
Address(number and street,city,state,country,and ZIP Code)
520 Main Street, Suite 1, Jasper, Indiana 47546
I. SELLER(S)/GRANTOR(S) P
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyancecuuifent jam.
Estate f Mama B Miller 6
Address(number and street) \� Address(number and street) NQv -Q�.,i
k-C6� w . \34r+ ,,'` Cc- a
City,state,and ZIP Code City,state,and ZIP Code 0Z
Z
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Country Country COON 9�['
E-mail address
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.
Signature of Seller ! Signature of Seller
Printed Name'of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Patrick B.Briggs,Personal Representative 11/21/2022
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
Brenda S. Norman
Address(number and street) Address(number and street)
City,state,and ZIP Code City,state,and ZIP Code
Country Country
E-mail address
for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
O 1.Will this property be the buyer's primaryN. 0 3. Homestead
residence? O p 4.Solar Energy Heating or Cooling System
la O 2.Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
for this residence?If yes,provide address: p p 6.Hydroelectric Power Device
Address(number and street) 0 Q 7.Geothermal Energy Heating or Cooling Device
'-)'1'—1 Z M L c7.I) L
City,state,ZIP code,and county 3
Under penalties of perjury,I hereby certify that 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 omits or falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spouse's