Homestead_Demaree •
H. PREPARER
Preparer of the Sales Disclosure Form Title
Jeffrey H.Bosse Settlement Agent
Company Email Address
Address(number and street,city,state,country,and ZIP Code)
4799 Rosebud Lane, Newburgh, IN 47630
I. SELLERS)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on conveys ent
Kyle Bullington
Address(number and street) Address(number and street)
609 N.Seminary St. ,Sj
City,State,and ZIP Code City,State,and ZIP Cod '. .:., \>).\
GGO
Princeton, IN 47670 0y 9 g,
Country Country esO,L ���
US CI
c2
yGo_ )
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,Is tru6',..„- and complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and Intentionally fats 'Eli the value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Si t re of Seller • Signature of Seller
1L
Prin d Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Kyle Bullington 08/07/2023 1 08/07/2023
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
Elden Demaree ,
Address(number and street) Address(number and street)
City,State,and ZIP Code City,State,and ZIP Code
Country Country
US
( )
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
® 1.Will this property be the buyer's primary () 0 3. Homestead
residence? 0 (I 4.Solar Energy Heating or Cooling System
11 O 2.Does the buyer have a homestead to be vacated 0 0 5.Wind Power Device
for this residence?If yes,provide address: p ® 6.Hydroelectric Power Device
Address(nurrlRer psi street) 0 ( 7.Geothermal Energy Heating or Cooling Device
1)aLW' r,1 -N(ll
City,Stat and ZIP Code County
W) 0 "1-N1to D6 -12- - 1 -7-01 -001.211- 02-2
Under penalties df 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 6-1.1-6.5.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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