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HomeMy WebLinkAboutHomestead_Brucks (3) 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, 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 Raymond D. Burton Tina K. Burton Address(number and street) Address(number and street) 1311 E Taft Town Road 1311 E Taft Town Road City,state,and ZIP Code City,state,and ZIP Code Princeton, IN 47670 Princeton, IN 47670 Country Country USA USA E-mail 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. ature of Seller Signaturof'Sefler r , CY1,46/, . a21/ 6,4/ Pri ed Name of Seller Date signe (m dd/yyyy) Printed Name of Seller Date signed(��m/dd/yyyy) Rayond D. Burton Tina K. Burton �3�/alaa�l 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 C. Brucks Address(number and street) Address(number and street) 415E Broadway P14 City,state,and ZIP Code City,state,and ZIP Code Princeton, IN 47670 A1A Q Country Country /l 1)41 E-mail address `S()NC' Q ( ) Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Idenakfiir that apply: V. YES NO CONDITION YES NO CONDITION 40 O/ Q O O 1.Will this property be the buyer's primary O 0 3. Homestead r°/? residence? 0 O 4.Solar Energy Heating or Cooling System 2. Does the buyer have a homestead to be vacated O O 5.Wind Power Device O O for this residence? If yes,provide address: 0 O 6. Hydroelectric Power Device _5 Address(number and street) 0 Q 7.Geothermal Energy Heating or Cooling Device ` 415E Broadway 0 City,state,ZIP code,and county Princeton, IN 47670 26.)Z-C i� - Lt OO -OO 1 . 38 O 2� Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete "7-- 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. (Note:Both spouse's (��J( Page 3 of 5