Homestead_Dehaven H. PREPARER
• Preparer of the Sales Disclosure Form Title
Carl A. Cameron Client Services Rep
Company
Address (number and street, city, state, country, and ZIP Code)
500 N. Broadway, Ste 900, St. Louis, MO 63102
I. SELLER(S)1GRANTOR(S)
-
Seller 1 — Name as rt appears on conveyance document Seller 2 — Name as appears on conveyance document
Aaron Warner DeHaven Trisha Lynn DeHaven
Address (number and street) Address (number and street)
1673 Dunlap Drive 1673 Dunlap Drive
City. State, and ZIP Code City, State, and ZIP Code
Princeton, IN 47670-8630 Princeton, IN 47670-8630
Country
Under penalties of perjury, I hereby certify 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 emits or falsifies any information required to be provided, commits a Level S felony.
Sign of Se Signature of Seller
I.- 1r0/A./ A , -,,,, -- z_oe,,,,./ (1
Printed Name of Seller Date Signed (mm/dd/yyyy) Printed Name of Swr Date Signed (mm/ddtyyyy)
Aaron Warner DeHaven ri- z z-ZO z.5- Trisha Lynn DeHaven l \ / Jac -
' J. BUYER(S)/GRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT APPLY
Buyer 1 — Name as `t appears on conveyance document Buyer 2 — Name as rt appears on conveyance document
Trisha Lynn DeHaven
Address (number and street) V Address (number and street)
1673 Dunlap Drive I ED
City, State, and ZIP Code City, State, and ZIP Code
Princeton, iN 47670-8630
, Country Country 06-c 0 n
USA J 2025
f
Email Address
apply for certain deductions. lden T iIIyf Vppty:
YES NO CONDITION YES NO CONDITION DI TOR
D 1. Well this property be the buyer's primary 0 0 3. Homestead
CZ residence? 0 0 4. Solar Energy Heating or Cooling System
O 2. Does the buyer have a homestead to be vacated 0 0 5. VVind Power Device
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, and ZIP Code County o )�� _ --0 3 k _5-- z4 .
.____1
G l o D
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct, and complete
, ,.' 44
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