Homestead_Bouchie H. PREPARER
Preparer of the Sales Disclosure Form Title
Daphne Kramer Paralegal
Company
Address(number and street,city,state,country,and ZIP Code) 1
226 W Broadway St., Princeton, IN 47670
I. SELLER(S)/GRANTOR(S) ,Q/) 4()
Seller 1-Name as it appears on conveyance document Seller 2-Name s appears on conIibnc document
Keith Messick Cindy Messic '0
Address(number and street) Address(numale et)
8719E360S 8719E360S Otye '2
City,slate,and ZIP Code City,state,and ZIP Code OViL '
Oakland City, IN 47660 Oaklanda City, IN 47660 �'4Untry y
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 w knowingly and Intentionally falsifies the value of transferred
real property,or omits or falsifies any information required to be provided, mils a Level 5 felony.
Sigma roof Seller m ACE SI gfure of Seller
- `0 AC -lt.1-�L1 // .44, ,
Printed Name o Seiler Date)sign (mm/dd/yyyy) Printed Name 6f Selle f Date signed(mm/dd/yyyy)
Keith Messick 41/?/�Z4f Cindy Messick ',I_ _,�,/
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTYTAX DEDUCTIONS—IDENTIFY ALL THAT APPLY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document
Thomas pia. B v 1/4,.4'h-1 1y Beverly Bftiskie V,o>^c}`,
Address(number and street) Address(number and street)
CV-g b 3 S 3Go [i, ' $ °.3 .5 3Oc ( ✓
City,stare,and ZIP Code _ City,state,and ZIP Code
li/ 5.4i, ,i _1 iti 1/20/ UJcAstn;1^c-1 -, siNI. LA-7sa
Country Country
USA USA
E-mail address
YES NO CONDITION YES NO CONDITION
0 O 1.Will this property be the buyer's primary D 0 3. Homestead
residence? 0 O 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
for this residence?If yes,provide address: 0 p 6.Hydroelectric Power Device
Address(number and street) 0 l 7.Geothermal Energy Healing or Cooling Device
City,state,ZIP code,and county
26-13-34-100 - 00( . 64 - (06