Homestead_Maddox (2) . • •
. _
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 convey cume
Estate of Joyce A.Allen
4 0
Address(number and street) Address(number and street)
503 S 8th Avenue . JO
City,state,and ZIP Code City,state,and ZIP Co 25
Haubstadt,IN 47639 . 202.5
Country Country (/6,,
US °OA,
C00--C ? ,...,
- r 4,6_ 1., •
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is true,correbrAlld complete as
required by law,and is prepared in accordance with IC 6-1.14.5.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.
Si alure of&Heti-n Signature of Seller
—K.
Printed Name of Seller Date signed(mmIddlyyyy) Printed Name of Seller Date signed(mm/dcityyyy)
Ronald Allen Jr.,Personal Representative Doi/2,4./a)25
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
Reed A.Maddox Melissa A.Maddox
Address(number and stree() Address(number and street)
• 105 Wolfe Street 105 Wolfe Street
City,slate,and ZIP Code City,state,and ZIP Code
Oaktown, IN 47561 Oaktown,IN 47561
Country Country
US US
k o 1.Will this property be the buyer's primary
residence? 0 0 3.Homestead e R
A
0 E 4.Solar Energy Heating or Cooli *•• 7-• ,i .4_,-,, ..
s, -44
x csi 2.Does the buyer have a homestead to be vacated 0 0 5.Wind Power Device f: ,_.., ,.1,•-•-•-.• ;:;•,?e.,:i7"
- ,
for this residence?If yes,provide address: 0 0 6.Hydroelectric Power Device I
Address(number and street) 0 E 7.Geothermal Energy Heating or Cooling Device
( 0 5 tkioLfe- $T-
City.state.ZIP code.and county %-22 —06-'2-00-000 17 6—D02
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
.
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