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HomeMy WebLinkAboutHomestead_Wethington H. PREPARER Preparer of the Sales Disclosure Form Title Seth D Haley In-House Attorney Company Address(number and street,city,state,country,and ZIP Code) 215 Main St, Lynnville, IN 47619 I. SELLERS)/GRANTOR(S) Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyance document LNB Community Bank Address(number and street) Address(number and street) PO Box 126 City,State,and ZIP Code City,State,and ZIP Code Lynnville, IN 47619 /U Country Country 46' 04, Q ( ) Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and bedF14fj j e,correct and mplete as required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionall"yq the va a sferred real property,or omits or falsifies •ny information required t be provided, iit Seller Level 5 felony. O/r0�9 / Si; cure of:�er_ f .� Signature - Re3 CEO Printed Nam- o /er Datetigned(mm/dd/yyyy) Printed Name of Seller Date Sigbea( dd/yyyy) LNB Community Bank 07/14/2023 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 Kohyn Avery Wethington Address(number and street) Address(number and street) 102 N 4th St City,State,and ZIP Code City,State,and ZIP Code Francisco, IN 47649 Country Country certain deductions.Identify all of those that apply: YES NO CONDITION YES NO CONDITION 1.Will this property be the buyer's primary ❑✓ ❑ 3. Homestead ❑ residence? ❑ ❑✓ 4. Solar Energy Heating or Cooling System 2.Does the buyer have a homestead to be vacated ❑ ❑✓ 5.Wind Power Device ❑ ❑✓ for this residence? If yes, provide address: ❑ ❑✓ 6. Hydroelectric Power Device Address(number and street) ❑✓ 7. Geothermal Energy Heating or Cooling Device City,State,and ZIP Code County C)/ -302-000 121 -0 0-�