Homestead_Herd H. PREPARER
Preparer of the Sales Disclosure Form Title
Lisa Tant Indiana Closing Agent
Company
Address(number and street,city,state,country,and ZIP Code)
114 Bauer Avenue, Louisville, KY 40207
I. SELLERS)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on c a ument
Timothy Davidson
Address(number and street) Address(number and street)
lio E, 5er(4 (:e 3 )' N '/
City,state,and ZIP Code City,state,and ZIP Code O 0
Pr„14e.A-on /1diQ�1Q ` 76) 70 „23
.%
Country Country e
US Gas,
O
the best of my knowledge and belief,is true,c>r49t 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.
Sigivtsre�f Sell ,, [ n/ Signature of Seller
Printed Name of S er Dat signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Timothy Davidson 1�I(p 2DL?
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
Darren Herd
Address(number and street) Address(number and street)
850 East Spruce Street
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670
Country Country
U.S I\
apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
O ❑ 1.Will this property be the buyer's primary ❑ ❑ 3. Homestead
residence? ❑ El 4.Solar Energy Heating or Cooling System
El El for
Does the buyer have a homestead to be vacated El ❑ 5.Wind Power Device
for this residence? If yes,provide address: ❑ 0 6. Hydroelectric Power Device
Address(number and street) ❑ 0 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county -1 Z-O y- q o 2 -00) .
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