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Homestead_Fieldbinder A . I H. PREPARER , Preparer of the Sales Disclosure Form Title i Daniel A. Moon Attorney Company � r Address(number and street,city,state,country,and ZIP Code) ! 1 1 1 N Hart Street, Princeton, Indiana, USA 47670 I. SELLER(S)/GRANTOR(S) FSeller 1 —Name as it appears on conveyance document Seller 2—Name as appears on conveyance document Diane Walter Ann Smith ' Address(number and street) Address(number and street) P. O. Box 157 5886 S 1075 W City,state,and ZIP Code City,state,and ZIP Code Princeton, IN 47670 Owensville, IN 47665 I Country I Country i ` USA USA E-mail address 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. j 'gnat ure of Seller a� , ,,.} Si ture of Seller p IPrinted Name of Seller Date signed(mm/dd/yyyy) Prin d Name of Seller Date signed(mm/dd/yyyy) Diane Walter ,: 'aA—o`ZD3 Ann Smith (0-2,U -2o2t J. BUYERS)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL T 'T APPLY rappears on conveyancedocument Buyer 2—Name as it appears on conveyanc-. +,u -' t 9 Address + + Address(number and street) 913 S GibsonStreetjj City,state, «ZIP CodeCity,state,and ZIP Code 4/0:/� 1Princeton, IN 47670 f.. , Country jCountry ii L+/QS �j� ©N to apply for certain deductions.Identify all of those t'a : YES NO CONDITION YES NO CONDITION 1.Will this property be the buyer's primary liel 0 3. Homestead residence? 0 Er 4. Solar Energy Heating or Cooling System O Ex 2. Does the buyer have a homestead to be vacated 0 o' 5.Wind Power Device for this residence? If yes, provide address: 0 (,7 6. Hydroelectric Power Device Address(number and street) 0 7.Geothermal Energy Heating or Cooling Device City,state,and ZIP Code County ��' /°_ 16- ao(-cico• 7 y 7-- o;K • Page 3 0 .y� 'A •t.: i • C • �i.