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Homestead_Seibert (12)
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) Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document Monica L. Brundage Address(number and street) Address(number and street) 1302 W Cloverdale Ct City,state,and ZIP Code City,state,and ZIP Code Haubstadt, IN 47639 Country Country Gibson County, Indiana best of my knowledge and belief,is true,correct and complete as required b� ,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred real pr9pe ,or. ri'S or falsifies any information required to be provided,commits a Level 5 felony. Sig / =t� Signature of Seller -Pr Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy) Monica L. Brundage 08232024 J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL T"' P-' Y Buyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appears on conveyanc-;(p o u n f Brett A. Seibert Lacy H. Seibert Address(number and street) Address(number and street) .61 373 E Hirsch Woods Ln 373 E Hirsch Woods Ln City,state,and ZIP Code City,state,and ZIP Code EP o' 0j4 • - ' Haubstadt, IN 47639 Haubstadt, IN 47639 / 2 ►‘,---1 Country Country Gibson County, Indiana Gibson County, Indiana GIBS N-.4.- ‘4-1 '.6;_ t 1 8 YES NO CONDITION YES NO CONDITION 1.Will this property be the buyer's primary O 0 3. Homestead O O O residence? O O 4.Solar Energy Heating or Cooling System C O 0 2.Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device for this residence? If yes,provide address: O O 6.Hydroelectric Power Device i Address(number and street) 0 0 7.Geothermal Energy Heating or Cooling Device 12646 S 200 E 7 City,state,ZIP code,and county `/' C'� Haubstadt, IN 47639 a4-a --6,i—a©Q—©©o'Z.fad-Da c Page 3 of 5 COPY ®