Homestead_Johnson (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Lindsay M. Phelps Searcher
Company
Address(number and street,city,state,country,and ZIP Code)
226 W Broadway Street, Princeton, IN, USA, 47670
I. SELLERS)/GRANTER(S)
Seller 1-Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Timothy A. Head Christy M. Englehardt
Address(number and street) Address(number and street)
617 Cardinal Drive 617 Cardinal Drive
City,state,and ZIP Code City,state,and ZIP Code
Patoka, IN 47666 Patoka, IN 47666
Country Country
USA USA
E-mail address
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
re rty,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Signatu of Seller Signye of Seller +
Printed Name �- Date signed(mm/dd/yyyy) ' Nam�eller/d ' Date signed(mm/dd/yyyy)
Timothy A. Head d'l6 .-e-3 Christy M. Englehardt c f(0. 63
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
Stephen D. Johnson Sandy Ann Johnson
• Address(number and street) Address(number and street)
502 Zimmerman Drive 502 Zimmerman Drive
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670 Princeton, IN 47670 PILE
1])
Count
N USA Country USAtry AUG ? , ,n9
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ri Pursuant to IC 6-1.1-12.44,the Sales Disclosure Form may be used to apply for certain deductions.IdegAS60416Whal viply:
0 YES NO CONDITION YES NO CONDITION COUN
P O O 1.Will this property be the buyer's primary O 0 3.Homestead rygVOOp
( residence? 0 O 4.Solar Energy Heating or Cooling System
O O 2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
for this residence?If yes,provide address: 0 p 6.Hydroelectric Power Device
0 Address(number and street) 0 0 7.Geothermal Energy Heating or Cooling Device
tv 502 Zimmerman Drive
City,state,ZIP code,and county n _ u_Z
Princeton, IN 47670 Lt. S -3n O 0 -o 0 . (o rl -0 20.
Under penalties of 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 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of
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