Homestead_Graper (7) 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
DONALD R. GRAPER LISA L. GRAPER
Address(number and street) Address(number and street)
5800 S 350 E 5800 S 350 E
City.state.and ZIP Code City,state.and ZIP Code
FORT BRANCH IN 47648 FORT BRANCH IN 47648
Country Country
GIBSON GIBSON
Under penalties of perjury,I hereby certify 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.
Sign re of Iler� Si natur f S
P in ed Name o Se ler Date s ned mm/dd/yyyy) Printed Name of Se ler (,A-1-4 Date si d m dd/YYYY)
}s 9 (
DONALD R. GRAPER 07/Z7/z0 2 3 LISA L. GRAPER 7 d
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THA APPL
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
ZANE A. GRAPER TESSA J. GRAPER
Address(number and street) Address(number and street)
3661 E 550 S 3661 E 550 S
City.state,and ZIP Code City.state.and ZIP Code
FORT BRANCH IN 47648 FORT BRANCH IN 47648
Country Country
GIBSON GIBSON
Pursuant to IC 6-1.1-12-44, Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply:
YES NO CONDITIO �+E e YES NO CONDITION
O O 1.Will this ro rt�/b t 1)1, rimary O O 3. Homestead
residence? O (2 4.Solar Energy Heating or Cooling System
0 O 2. Does thAl have a homestead to be vacated O O 5.Wind Power Device
for this residence ff yj ovide address: 0 O 6. Hydroelectric Power Device
Address number street) ��JJ 0 (2 7.Geothermal Energy Heating or Cooling Device
City.state,ZIP code.VAi� ryfj�
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