Homestead_Phillips (9) 1 H. PREPARER -^ a. -�:PTode—) ---
aa. �w� -- ) � � 1Preparer f the Sale Disclosure Form rTitleCompanyI
4799 Rosebud Lane,Newburgh.IN 47630
I.SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Cory Powell
Address(number and street) Address(number and street)
320 W.Oak St.
- -- ___ __ _ pit, _
City,State,and ZIP Code City,State,and ZIP Code
Princeton,IN 47670
Country Country
US
Email Address
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Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my kno and ballet,is v and complete as
required by law,and Is prepared in accordance with IC 8-1.1-5.5.A person who knowingly ntlonally falsifi the value of transferred
real property,t. ora oml falsifies any information required to be provided,commits a Lev
Signature o//y�II+e Signature of Seller p� ,q_,
• hName of Setter Date Signed(mmlddlyyyy) Printed Name of Seller 1"� Signed(mmlddlyyyy)
ory Powell k (1-3f/�� ilt› i
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY i
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document ;;
Dakota Phillirs _
Address number end treet) Address(number and•street)
City,Sta a and ZIP a City,State.and ZiP Code
«1.1C.an 1° ql fl()
Country Country
US
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Pursuant to IC 6-1.1-12 44,the Sales Disclosure Form may be used to apply for certain deductions.Identify ail of those that apply:
YES NO CONDITION YES NO CONDITION
9 I'
' / 1.Will this property be the buyer's primary 0 3.Homestead -
O ,
P residence? p ® 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 ® 5.Wind Power Device
O r"4 for this residence?If yes,provide address:
0 Q 6.Hydroelectric Power Device
Address(number and street) 0 ® 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County Ab� 12-(J1_ 101 _0 O I, ` i _,c)2 P
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct,and complete
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