Homestead_Priestly H. PREPARER
Preparer of the Sales Disclosure Form Title
Pamela Partenheimer Mick Attorney
Company
Address(number and street,city,state, country, and ZIP Code)
219 N Hart St, PO Box 13, Princeton, IN 47670
I. SELLERS)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on convey ment
Habitat for Humanity of Gibson County, Inc. 4,CC '
Address(number and street) Address(number and street)
1302 W. Brumfield Avenue
City,state,and ZIP Code City,state,and ZIP Cod ��y
Princeton, IN 47670 Io
Country Country �'Z"46' �01,
Gibson 4, `I
CP
knowledge and belief,is tru 90 and complete as
required by law,and is prepared in accordance with IC 6-1,1.5.5.A person who knowingly and intentionally falsifia4be value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
' atu�of Sell r Signature of Seller
Printed
Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
David Chamberlain, Vice President 04/28/2023
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
Tarren Priestly
Address(number and street) Address(number and street)
618 S Prince St
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670
Country Country
CONDITION
� ❑ 1.Will this property be the buyer's primary O O 3. Homestead
residence? ❑ O 4. Solar Energy Heating or Cooling System
❑ 2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
for this residence?If yes, provide address: O O 6. Hydroelectric Power Device
Address(number and street) ❑ Q 7. Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
Lfb3-6r1.2 ,qY - Dag
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
Y