Homestead_Lutz H. PREPARER
Preparer of the Sales Disclosure Form Title
Jeffrey R. Slaughter
Company
Address (number and street, city, state, country, and ZIP Code)
8310 Allison Pointe Boulevard, Suite 205„ Indianapolis, Indiana, 46250
I. SELLER(S)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document Seller 2 - Name as appears on conveya u e
Jason C. Brucks
Address (number and street) Address (number and street) ‘.
415 E. Broadway Street •
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City, state, and ZIP Code City, state, and ZIP Code �v�j'
Princeton, Indiana, 47670 <2S
Country Country G�7
USA USA ` '04(
E-mail address
of my knowledge and belief, Is true, cor{ r mplete as
required by la and is prepared In accordance with IC 6-1.1-5.5. A person who knowingly and Intentionally falsifies the vi of transferred
real property o omits or falsifies an Information required to be provided, commits a Level 5 felony.
Signature of e er Signature of Seller
C----
Printed Nair of Seller Date signed (mm/dd/yyyy) Printed Name of Seller Date signed (mm/ddlyyyy)
Jason C. rucks O SP- .!- p20 c"
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
Corey Lutz
Address (number and street) Address (number and street)
1311 East Taftown Road
City, state, and ZIP Code City, state, and ZIP Code
Princeton, Indiana, 47670
Country Country
USA USA
E-mail address
apply for certain deductions. Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
411 1. Will this property be the buyer's primary
residence? 3. Homestead
[� (� 4. Solar Energy Heating or Cooling System
Cx 2. Does the buyer have a homestead to be vacated 0 C 5. Wind Power Device
for this residence? If yes, provide address: a 3 6. Hydroelectric Power Device
Address (number and street) ig 7. Geothermal Energy Heating or Cooling Device
C ty, state, and ZIP Code County
6-12- O c- oo - 0 01 .3W - 0 2_.3-
C riciP
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