Homestead_Bradshaw c--r-N\i„1, g
H. PREPARER
Preparer of the Sales Disclosure Form Title
JAMES G. MCDONOLD. II ATTORNEY AT LAW
Company
I
Address(number and street,city,state,country,and ZIP Code)
120 S Main St, Princeton, IN 47670
I. SELLER(S)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Est Haskell Wallace by Terry L. Wallace
Address(number and street) Address(number and street)
6005 E SR 64 COp
Y ,.,i 1
City,State,and ZIP Code City,State,and ZIP Code gFrancisco, IN 47649
Country Country _.
United States
Email Address
( )
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.
Sig ature of Seller ., Signature of Seller
Prince me of seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Terry L. Wallace O'/2 '/2P23 V C
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
Jason A. Bradshaw
Address(number and street) Address(number and street)
( )
' ]
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to -pply for certain deductions.Identify all of those that apply:
YES NO CONDITION ES NO CONDITION
® D 1.Will this property be the buyer's ima\� " f / � L . 3. Homestead
residence? 0 O" 4. Solar Energy Heating or Cooling System
D/ # 2. Does the buyer have a homsstea• • :- vacated C3� 5.Wind Power Device 0
for this residence2ifyes—provide address: -�-- 0 p/ 6. Hydroelectric Power Device
Address(number and et) \J nl\ \‘./ S O/ 7. Geothermal Energy Heating or Cooling Device
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City,State,and ZI Code Countyn
P� r—J<\- 6- 13-13 - oo- ofs .3g9 —oo .6-
Under penalties o erjury,I ereb isclosure,to the best of my knowledge and belief,is true,correct,and complete
as required by law,a 's re ' accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of
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