Homestead_Wethington H. PREPARER
Preparer of the Sales Disclosure Form Title
Daphne Kramer Paralegal
Company
Address(number and street,city,state,country,and ZIP Code)
226 W Broadway St., Princeton, IN 47670
I. SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance docu t
Shelley Coscina Stephen Hemmer
Address(number and street) Address(number and street)
211 Posey Street 8480 S 950 E <(' `41
City,state,and ZIP Code City,state,and ZIP Code �'%-
Newburgh, IN 47630 Elberfeld, IN 47613 `r0,/ I
Country Country O u'
E-mail address Telephone number E-mail address i- phone number
( ) ado
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is true,cof! d complete as
required by law,and is prepared In accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies t value of transfe d
real property,or omits or falsifies any rmation required to be provided,co 's e I 5 felony.
Signature of Set / Sign rr
� ��� Cam. •
Print am of Seller mate sign (mm/dd/yyyy) Printed Name of Seller Date signed(mm/ddl
Shelley Coscina jam. zoz Stephen Hemmer
J. BUYER(S)IGRANTEE(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
Kohyn A.Wethington
Address(number and street) Address(number and street)
102 N Fourth Street
City,state,and ZIP Code City,state,and ZIP Code
Francisco, IN 47649
Country Country
E-mail address
( )
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
O O 1.Will this property be the buyer's primary O 0 3.Homestead
residence? 0 O 4.Solar Energy Heating or Cooling System
O (7 2.Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
for this residence?If yes,provide address: 0 E 6.Hydroelectric Power Device
Address(number and street) 0 11 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
26-12-0 7-303-001, -02g ,
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