Homestead_Murphy (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Pamela Partenheimer Mick Attorney
Company
Address(number and street,city,state,country,and ZIP Code)
219 N Hart St, PO Box 13, Princeton, IN 47670
I. SELLERS)/GRANTOR(S) V�
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyan o men
Rosita D.Smith
Address(number and street) Address(number and street) ,,//''
1522 E State Road 168 '7'4k I
City,state,and ZIP Code City,state,and ZIP C es 4�Q
FORT BRANCH, IN 47648 s
Country Country Uti
0 �Q
gibson L
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is tru 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.
Signatureof Seller Signature of Seller
P
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Rosita D. Smith 05032024
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
Shane Patrick Murphy
Address(number and street) Address(number and street)
1522 E State Road 168
City,state,and ZIP Code City,state,and ZIP Code
FORT BRANCH, IN 47648
Country Country
gibson
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 (30 3.Homestead
residence? 0 Q 4.Solar Energy Heating or Cooling System
O O 2.Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
for this residence?If yes,provide address: O p 6.Hydroelectric Power Device
Address(number and street) Q O 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county / -/n_ 1 ! —too
Ioo _ 060
00 04 -6 2_,
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copy