Homestead_Middleton 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. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
The Estate of DeAnn S. Parker Robert A. Lasley, Tenant In Common
Address(number and street) Address(number and street)
20525 Breezy Hill Drive 2029 SW White Church Rd
City.state,and ZIP Code City,state,and ZIP Code
Ashburn, VA 20147 Princeton, IN, 47670
Country Country
GIBSON
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Signature of Seller Signature
v ‘-
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Se er Date signed(mm/ddlyyyy)
Darin Urick,Personal Representative Robert A. Lasley, Tenant In Common 07/25/2023
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY L THAT APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on cony cument
Helen Theresa Middleton
Address(number and street) Address(number and street)
2029 SW White Church Rd
44).1
City.state,and ZIP Code City,state,and ZIP Code J/,
Princeton, IN,47670 ` J
Country Country G' ��1
• GIBSON /eSOilr `�
apply for certain deductions.Identify all 4,,+�• , •at apply:
I YES NO CONDITION
YES NO CONDITION R
O O 1.Will this property be the buyer's primary O 0 3. Homestead
residence? 0 O 4. Solar Energy Heating or Cooling System
0 O 2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
0 for this residence? If yes,provide address: 0 0 6. Hydroelectric Power Device
1
Address(number and street)
1513 S Jefferson Ave O O 7. Geothermal Energy Heating or Cooling Device
el)( City,state.ZIP code.and county
04/ Princeton, IN, 47670 56' l -- I LI-- 100— 00 1 . g—02-7-
t Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
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