HomeMy WebLinkAboutHomestead_Bullington -
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 a
Staci A. Davis ppears on con ocument
Address (number and street) Address (number and street)
7826 N 75 E
City, state, and ZIP Code City, state, and ZIP Code 1
Hazleton, IN 47640 ��
Country Country 06
us0/00
`'
the best of my knowledge and belief, is �,� and - -
complete as
required by law, and is prepared in accordance with IC 6-1.1-5.5. A person who knowingly and intentionally falsife9,t a value of transferred
real property, or omits or falsifies any information required to be provided, commits a Level 5 felony.
Slip ure of Seli r Signature of Seller - -
"rinted Name of Seller Date si ned ( m/dd D
/yyyy) Printed Name of Seller -1
Staci A. Davis n/kla Staci A. RichardsonzoQs ate signed (mm/dd/yyyy)
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 ap
pears r on conveyance document
Heather Lynn Buffington
Address (number and street) Address (number and street)
9218 Southport Dr
City, state, and ZIP Code City, state, and ZIP Code
Evansville, IN 47711
Country Country
us
a•pi for certain deductions. Identify all of those that a I
YES NO CONDITION Pp y
YES NO CONDITION
O 1. WNII this property be the buyer's primary CD 3. Homestead
residence?
0 O 4. Solar Energy Heating or Cooling System
O 2. Does the buyer have a homestead to be vacated 0 O 5. Wind Power Device
for this residence? If yes, provide address' Li Q 6. Hydroelectric Power Device
Address (number and street)
9218 Southport Dr 0 O 7. Geothermal Energy Heating or Cooling Device
City, state, ZIP code, and county
Evansville, IN 47711 -2 b - 1 Q'-'1 9 - 1 0 3 - 00 l . 101 \ --n Z()
Under penalties of perjury, I hereby certify hat this Sales Disclosure, to the best of my knowledge and belief, is true, correct and complete
Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
.Q.)
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