Homestead_Haniotis H. PREPARER ^
Prepaner of the Sales Disclosure Form Title
Kelly E Norton Settlement Agent
Company /�
4799 Rosebud Lane,Newburgh,IN 47630 c
I. SELLER(S)IGRANTOR(S)
•
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Hillandale Investments Properties LLC more correctly known as Hilland.
Address(number and street) Address(number and street)
132 Hillandale Dr -( T
City,State,and ZIP Code City,State,and ZIP Code
D
Somerset,KY 42501
Country Country 0CT-(79 ?024
US
best of my knowledge and brifire1 it and complete as
required by law,and Is prepared In accordance with IC 6-1.1-5.5.A person who knowingly and Intentionally fallss f alue of transferred
real property,or omits or falsifies any Information required to be provided,commits a Level 5 felony.
Signature S ller / . Signature of Seller
Printed Name•f SOO' Date Signed +• Printed Name of Seller Date Signed(mmldd/yyyy)
J. BUYER(S)IGRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1—Name as it appears on conveyance document Buye 2—Name as it app .„q on cyliveyance document
Andrew Haniotis 6 *ti 14 l a +
Ad.dppress(num rand street) a ..
CityrState,ond ZIP Code ,,, Cit State,arid ZIP Code A.
Country Country
US
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
1.Will this property be the buyer's primary < 0 3.Homestead
)1( 0 residence? 0 ® 4.Solar Energy Heating or Cooling System
p Does the buyer have a homestead to be vacated 0 ® 5.Wind Power Device
for this residence? If yes, provide address: 0 ® 6. Hydroelectric Power Device
Address(number and street) 0 () 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County P - - 1. - O1k-0.0( . 2 LkA -0 0