Homestead_Hyneman H. PREPARER
Preparer of the Sales Disclosure Form Title
James G. McDonald, III
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
Bret D. Hyneman Cynthia L. Beard
Address(number and street) Address(number and street)
6370 N SR 65 6728 N SR 65
I )
City,State,and ZIP Code City,State,and ZIP Code V-°
Hazleton, IN 47640 Hazleton, IN 4 2a1ttcc i
Country Country PQo 0
United States United States
Email Address
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intenticifies the value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
'gnat e of Seller Si nature of Seller
p. v►;_� 0. tL
Printed Name of Se er Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
' Bret D. Hyneman Cynthia L. Beard
J. BUYER(S)/GRANTEE(S) —APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
r Buyer 1 -Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
Bert D. Hyneman Ann M. Hyneman
Address(number and street) Address(number and street)
6394 N SR 65 6394 N SR 65
• City,State,and ZIP Code City, State,and ZIP Code
Hazleton. IN 47640 Hazleton, IN 47640
✓ Country Country
United States United States
Email Address
YES NO CONDITION YES NO CONDITION
1. Will this property be the buyer's primary 3. Homestead
residence? 0 0' 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 LV 5. Wind Power Device
" 0 O� for this residence? If yes, provide address: 0 [ 6. Hydroelectric Power Device
Address(number and street) 0 d 7. Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County n/ _0 . ,sZ— iri��co Is,z..,,,o13.
Under penalties of perjury,I hereby certify that this Sales Disclosure,to thee best of my knowledge and belief,is true,correct,and complete
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