Homestead_Black (3) 1 H. PREPARER ___J
Preparer of the Sales Disclosure Form Title
Stephanie L. Black Buyer
Company
Address(number and street,city,state,country.and ZIP Code)
121 N Embree St, Princeton, IN 47670
I. SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conve ce c ent
ntey{tykuestng,1LCbyTheDavd1 Largxn and AutLc ,L Largham Rev ocaL LivIT htegrfty hvestirg,LLCbyTheDavd1 Langhamand Autumn L 1 Reva
Trr a flate1 ru.nx?n19by navri t i argh.unC Tr rtee Tw5i-Pated4N-'2 29414frAattiffi `1.3vghaRACe-7d4ee
Address(number and street) Address(number and street)
354 S 180E 354 S 180E ✓o, ?8
City,State.and ZIP Code City.State.and ZIP Code ClQe
Princeton, IN 47670 Count
ryceton, IN 476'J�oa n
CC
United States United States NrYb`
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and' tentionally falsifies the value of transferred
real pro ,or omits or falsifies any information required to be provided,commits a Level 5 • ony.
Signal re f S.eIler Sig ature of Ilex
G-z-1 — lJt n
P ed Name of S r Date Signed(mm/dd/yyyy) Printed Name S'ler Date Signed(mm/dd/yyyy)
David J. Lan•ham Co Trustee _ 7- 7-2 Autumn L. Lan:.hamLCo_Trustee —
J. BUYERS)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIO f -IDENTIFY ALL THAT APPLY
Buyer 1 -Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
Bradley S. Black Stephanie L. Black
Address(number and street) Address(number and st eet)
121 N Fmbree St /c2 / N 1 lb bra 5-7`.
C' State and Z�P,Cgd�670 C. .State.and ZIP Code
F'nnceton, IV 4/
Country Country
United States United States
YES NO CONDITION YES NO CO ION
1.Will this property be the buyer's primary 0 0 3 0 • --r
residence? 0 0 4 r -.;y ng r Sy tem
2. Does the buyer have a homestead to be vacated 0 0 5.Wind Powe e e
for this residence?If yes, provide address: 0 0 6. Hydroelectric Power Dev e
Address(number and street) 0 0 7. Geothermal Energy Heating or Cooling is
City,State,and ZIP Code County
0210- II-t - a00- OOO•9Q1-Q> -
Under penalties of perjury,1 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