Homestead_Wolfe H. PREPARER
Preparer of the Sales Disclosure Form Title
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Company E-mail address
Address(number and street,city,state,country, and ZIP Code)
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I. SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document" :,.. .....„
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Address(n mber and street) Address(number a stree - V
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City.state,and ZIP Code City,state,and ZIP Code ;; �
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Country Country
O
knowingly and intentionally falsifies the I of tr n red
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Signs of Seller Signature of Seller
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Printed Na of Seller Date signed(mm/ddlyyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
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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
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Address(number)nd street) Address(number and street)
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City,state,and ZIP Code City,state,and ZIP Code
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Country Country
YES NO CONDITION YE� C NO ONDITION
1.Will this property be the buyer's primary O C Homestead
Vresidence? 0 �1 Solar Energy Heating or Cooling System
c/2.Does the buyer have a homestead to be vacated O •Wind Power Device
0 for this residence? If yes,provide address: 0 L� Hydroelectric Power Device
Address(number and street) 0 9 -. Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county 38
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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
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