Homestead_Lumabi H. PREPARER � • ---- r Yy ` • `• 1.•• • • •• 'i t.•' ,• 4tsw,- ,�. t • •`�s�{'�• �• �• om•
Preparer of the Sales Disclosure Form Title
Jill Gilillan Deed Specialist
Company Email Address
Address (number and street, city, state, country, and ZIP Code)
660 Woodward Avenue, Detroit, MI 48226
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I. SELLERS)/GRANTOR(S) �:: • :
� � .��,�'•' ` •,' • ,•' '- .:r • •••.,• .i,-30- _�,,_[{''���,'.". : k,:�•�;: '•.• 7-/'' �": •�'?
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Seller 1 - Name as it appears on conveyance document Seller 2 --Name as appears on conveyance document
Virginia Canillas Venerio Canillas
Address (number and street) Address (number and street)
411 West Spruce Street 411 West Spruce Street
City, State, and ZIP Code City, State, and ZIP Code
Princeton, IN 47670 Princeton, IN 47670
Country Country
USA USA
Email Address
required by law, and is'prepared.In accordance'with,IC 6.1.1-5.5:A pers on`who,kndG ngly.artd•intentlorfalty falsifies the,valu ,p •traaihsfemetlt
real property, or omits or falsifies any Infonnationequired to be provided, commits•a;Level:5:felony. ' *. ,i; pt; • •
Signature of S- ler S' ure of seller
Printed Name of Seller Date Si ned (mm/ddiyyyy) Printed Name of Seller Date S'.ned ( m/dd/yyyy)
Virginia Canilla Oq I• .07/ Venerio Canillas /i 4.2/
.J. BUYERS)/GRANTEE(S) 7 APPLICATION FOR PROPERT, TAX'DEDUC,TIONS IDENTIFY AL'L THAT APPLY; r• ; '*-•
Buyer 1 - Name as it appears on conveyance document Buyer 2 - Name as it appears on conveyance document
Alfredo Lumabi
Address (number and street) Address (number and street)
407 North Race Street
City, State, and ZIP Code City, State, and ZIP Code
Princeton, IN 47670
AMIE
Country Country
USA s:�-- AAMIE
—
Email Address
•I f• '+: °•e•' r f, Identify all o se that'apply
YES NO CONDITION YES NO CONDI I%att,,��C�
❑ 1. Will this property be the buyer's primary pe 0 3. Homesto
residence? ❑ Cy 4. Solar Energy ll Z •or Cooling System
❑ 2. Does the buyer have a homestead to be vacated 0 C 5. Wind Power Device'?
for this residence? If yes, provide address: 0 0.° 6. Hydroelectric Power Device
Address (number and street) ❑ 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County
002 . 4y � - 02S
Under penalties,of perjury;1 hereby certify-th'at thls Sales Disclosure, to the best of my knolôdgoand bblicf, is true, correct,;and complete •
'as required,by law, and isprepared In accordance with IC 6-14-5.5. A person-who knowingly and'.lntentionally falsifies the value'of
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