Homestead_Glover t"
-f
.4;
'r' TH. PREPARER
Preparer of the Sales Disclosure Form Title
Gabriella VanAlstine Escrow Assistant
Company
Address(number and street,city,slate,country,and ZIP Code)
520 Main Street, Suite 1, Jasper, IN 47546
I. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document
Kyle Allan Buckman Seller 2-Name as appears on convey d nt
--y_b
Address(number and street) Address number' 169 State Route 810 N ( e and street) ...6
City,State,and ZIP Code AA
City,State,and ZIP Code Op /,
Kuttawa, KY 42055 ?O?
Country Country
Lail Address
of my knowledge and belief,Is true,correct,and'omplete 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 ,
X rl e/ _ v t -n� Signature of Seller
Printed Name of Seller �j Date Signed(mmlddlyyyy) Printed Name of Seller
Kyle Allan Buckman 04/03/2023 Date Signed(mmlddlyyyy)
N
J. BUYER(S)/GRANTEE(S) --APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY AL HAT APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as It appears ppears on convey ce .�,av„ant
Jonathan P. Glover
Amber N. Glover
Address(number and street)
_
1256S200W
Address(number and street) 'Allik° "`
Same
City,State,and ZIP Code City,State,and ZIP Code
Princeton, IN 47670 Same
Country Country
—
O O 1.Will this property be the buyers primary 00 3. Homestead
residence?
0 O✓ 4.Solar Energy Heating or Cooling System
O 2.Does the buyer have a homestead to be vacated 0 O 6.Wind Power Device
_/ for this residence? If yes,provide address: CI 06.Hydroelectric Power Device
O \fddress(number and street)
e\k a_ ;-- 3-Nr..XW � 0 07.Geothermal Energy Heating or Cooling Device
rO City,State,and ZIP Code
County
),« 7 : L1 (.o-1b A, 11-14- l't00-001 .tW9 '- 027
'N Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct,and complete
\1, 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
6 u information,SSAI/Driver's License/ID/Other Number is necessary only if a Homestead Deduction is being filed.)