Homestead_Miskell (3) 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. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on ve a cument
Magen D.Gillihan
Address(number and street) Address(number and street)
713 E State St /4>A
City,state,and ZIP Code City,state,and ZIP _-de
<-
Princeton, IN,47670
0 0e, 42)1.
Country Country
Gibson
°O,c2
my knowledge and belief,i , rect and complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally fa es the value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Si7Zre of eller Signature of Seller
AUA
rint NrIe of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Magen . Gillihan -clod 5
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
Anthony Miskell
Address(number and street) Address(number and street)
608 S Main St
City,state,and ZIP Code City,state,and ZIP Code
Owensville, IN 47665
Country Country
Gibson
for certain deductions.Identify all of those that apply:
YES NO CONDITION YE . NO CONDITION
0 1.Will this property be the buyer's primary
0 3.Homestead
residence?
0 0 4. Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 E 5.Wind Power Device
0 V for this residence?If yes,provide address: 0 0 6. Hydroelectric Power Device
Address(number and street) 0 0 7. Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county '2_6-OA -24-Z0S-coo. 4 Li ca-02o
Under penalties of perjury,I hereby certify that 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 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,(Note:Both spouse's
5
4.„
•