Homestead_Dunn H. PREPARER
Preparer of the Sales Disclosure Form Title
Melissa Baker Closer
Company
Address(number and street,city,state, country,and ZIP Code)
26 W. Broadway Street, Princeton, IN 47670
I. SELLER(S)IGRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveys e document
Linda K.Willis Max Willis
Address(number and street) Address(number and street). .
,
City,state,and ZIP Code City,state,and ZIP Code
Country Country v/0
USA USA Oz4,
(704,2i
E-mail address
the best of my knowledge and belief,i orrect and complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally fa e value of transferred
real pp erty,or omits or falsifies any information required to be provided,commits a Level 5 felony. 19
rekof Seller /-\/,/ kJSignalu5e of Sell9r,
ri tedName of Seller Date signed(mm/dcl/yyyy) Printed Name of Seller, . Date signed(mm/dd/yyyy)
Linda K:Willis i Max Willis 1/// /2— 3
i.01:43:vy.ER(§)/QRANTEE(s)—APPLICATION FOR PROPERTY.TAXE0..1.0TIQNiDENTIFY ALL THAT APPLY
. • -
•• Name as it appears on conveyance document Buyer 2=..Name:ss.it.appears on conveyance document
:AddreSS'(i-iiirrWand"street) • ' 'Address •• •
-547:S 1225
" • •
. City state and ZIP Code •
0411014'041,:iit41600-USA
Country - Country
. .
E-mail address
*
- )
. .
•
Pursublitio IC6-1.1-12-44, the Sales Disclosure Form may be used to apply for'certain deductionS.Identify all of those that apply:
• .YES .:CONDITION YES • NO CONDITION
' • 1.Will this property be the buyer's primary 1 0 Homestead
0 0 residence? 0 IJ 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 0 5.Wind Power Device
0 0 for this residence?If yes, provide address: 0 0 6. Hydroelectric Power Device
Address(number and street) 0 0 7. Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
ac- -Ai -1-9 I- 00‘.6iy-_c)
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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t1'4.
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