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Homestead_Long (3)
H. PREPARER Preparer of the Sales Disclosure Form Title �'I .1Acs 6- /tA` ✓ ftia1 ATv,zive-IT Company Address(number and street,city,slcie,country,y.nd ZIP Code, Izo s /YlaiN ` eI/U ,,— ...i 47‘7) I. SELLERS)/GRANTOR(S) Seller 1-Name as it ap ars on conveyance d current Seller 2-Name as appears on conve nc ocument �� s�A �,.fy 1ici1 L it L LC Address(number and stree' Address(number and street) e 0 (5" ZI Li/ 446),,1 City,stp and ZIP Code -6 ZG 7J City,state,and ZIP Code 46, Country Country bt s ' O'eso ©17 E-mail address �'tiiyo ( ) Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is1 'rect and compl: e a required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falst!f> R e value of trans •rred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. Signature of Seller Signature of Seller Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy) 111a4'K 34-1i-c c �._ © S/L71 z(dz-� - J. BUYERS)/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 Ue,i ►tiGiv-- LQ est Li Address(number and street) Addre mber and street) 317 0 . 55c/ C -Si City,state,and ZIP Code City, tat ., a r Nue .+ .Z.t Lf 767, fiVIR1 . Country U S Country E-mail address Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply: YES NO CONDITION YES NO CONDITION [2' O 1.Will this property be the buyer's primary C( 0 3. Homestead residence? 0 C17- 4. Solar Energy Heating or Cooling System iii 2. Does the buyer have a homestead to be vacated 0 i 5.Wind Power Device for this residence? If yes, provide address: 0 (a' 6. Hydroelectric Power Device Address(number and street) 0 V 7. Geothermal Energy Heating or Cooling Device City,state,and ZIP Code County 6-1Z- 01-tol- 001. 121 -© Z$ ccwv