Homestead_Fleming (4) H. PREPARER 1
~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. SELLERS)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2 —Name as appears on conveyance document
Kimberly Martin Kelly Harris
Address (number and street) Address (number and street)
305E Strain St 1161 W SR 68
City, state, and ZIP Code City, state, and ZIP Code
Fort Branch, IN 47648 Haubstadt, IN 47639
Country Country
us Us
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 omits or falsifies any information required to be provided, commits a Lev 5 felony.
Signature of eller Signature of II
b"riCt)--t'
rimed Name of Se r Date signed (mmldd/yyyy) Printed Name of Seller ya4.4....>2
Date signed (mm/dd/yyyy)
Kimberly Martin 12/19/2025 Kelly Harris 12/19/2025
J. BUYER(S)/GRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY LL THAT APPLY
Buyer 1 —Name as it appears on conveyance document Buyer 2 — Name as it appears on co ument
Kern Fleming
Address (number and street) Address (number and street)
1177WSRLk -t14-- i
City, state, and ZIP Code City, state, and ZIP Code Dee
Haubstadt, IN 47639 30
Country Country` - , 4 75
us G/8
apply for certain deductions. Identify all of ply:
YES NO CONDITION YES NO CONDITION • ?'0/9
0 O 1. WII this property be the buyer's primary C� [1] 3. Homestead
residence? Q L7 4. Solar Energy Heating or Cooling System
O O 2. Does the buyer have a homestead to be vacated 0 0 5. Wind Power Device
1---).) for this residence? If yes, provide address: 0 O 6. Hydroeiectnc Power Device
4 Address (number and street) 0 0 7. Geothermal Energy Heating or Cooling Device
�L 1177WSR68
CO.. . . City, state, ZIP code, and county �� r- 22 -o) 1f�.J nL�DU3 22
1
� - . Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, Is true, correct and complete
L* L _ 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 omits or falsifies any information required to be provided, commits a Level 5 felony. (Note: Both spouse's
information, SSN/Driver's License/ID/Other Number is necessary If a Homestead Deduction is being filed.)
5
SALES DISCLOSURE: ADDITIONAL PAGE 3
LI. SELLER(S)/GRANTOR(S)
Seller 3 - Name as it appears on conveyance document
Kerri Fleming
Address (number and street)
1177 W SR 68
City, state, and ZIP Code
Haubstadt, IN 47639
County
gibson
Email address
kfleming561@yahoo.com
Telephone number
812-664-2890
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 omits or falsifies any information required to be provided, commits a Level 5 felony.
Si n ture of Iler
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Printed Name of Seller
Kerri Fleming
Date signed (mm/dd/yyyy)
12/19/2025
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