Homestead_Price (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)/GRANTER(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conv ace oc ent
K.C. Daniels Raley �l
Address(number and street) Address(number and street) -0)
2668 W Jill Dr S'FA
City,state,and ZIP Code City,state,and ZIP Code � '8
Princeton, IN, 47670 C 20�3
Country Country ON
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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.
Signature of Seller Signature of Seller
Printed Name o le r Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy))
K.C. Daniels Raley ORfbef S
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
Aaron Price
•
Address(number and street) Address(number and street)
2668 W Jill Dr
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN, 47670
Country Country
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for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
O O 1.Will this property be the buyer's primary O 0 3. Homestead
residence? O O 4.Solar Energy Heating or Cooling System
O O 2.Does the buyer have a homestead to be vacated 0 CI 5.Wind Power Device
for this residence? If yes,provide address: 0 O 6.Hydroelectric Power Device
Address(number and street) O O 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
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