Homestead_Payne (3) 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. SELLERS)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Christopher Marsh Misti Marsh
Address(number and street) Address(number and street)
1636 Birchwood Dr 1636 Birchwood Dr
City,state.and ZIP Code City.state,and ZIP Code
Princeton, IN 47670 Princeton, IN 47670
Country Country
gibson gibson
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 prop y,or omits or falsifies any i formation required to be provided,commits a Level 5 felony.
Sign of r Signatr of elle r
Printed Nam of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date si1J3
ed( m/dd/yyyy)
x ✓'• 10/4" /(107 ' L aC// 23 �l s f►' YYIQk f- , I( a,
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 appe s onveyance document
Jared Payne
Address(number and street) Address(number and street)
517 N Hart St
City.state.and ZIP Code City,state,an ZIP CodeSebb
Princeton, IN, 47670 1 s
Country
(7.Country f'7eS, N 2012
gibson
E-mail address
YqV ( )
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identifyc of those that apply:
YES NO CONDITION YES NO CONDITION
O 0 1.Will this property be the buyer's primary O 0 3. Homestead
residence'? 0 O 4. Solar Energy Heating or Cooling System
0 0 2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
for this residence'? If yes, provide address: 0 O 6. Hydroelectric Power Device
Address(number and street) 0 0 7. Geothermal Energy Heating or Cooling Device
City.state,ZIP code.and county
Ala- - Do
of 5