HomeMy WebLinkAboutHomestead_Driscoll H. PREPARER
Preparer of the Sales Disclosure Form Title
Daniel L. Siewers Attorney at Law
Company
Address (number and street, city, state, country, and ZIP Code)
513 Main St., Vincennes, IN 47591
I. SELLER(S)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document Seller 2 - Name as appears on conveyance document
Ronald D. Burns Donald L. Burns
Address (number and street) Address (number and street)
2761 W. Jill Dr. I 0 2,. .Z Q -.) ,,y i L C A0 55 ,6,1E,
City. State, and ZIP Code City, State, and ZIP Code
Princeton, IN 47670 - 14 c-1 3 5 i A 6 I '`i 41 7 3 4
Country Country
USA USA G i (3 5w.EJ
Email Address
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.
Signature of Sell Signature of Seller
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Printed Name of Seller Date Signed (mm/dd/yyyy) Printed Name of Seller Date Signed (mm/dd/yyyy)
Ronald D. Burns 02/05/2026 Donald L. Burns 02/04/2026
J. BUYER(S)/GRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTII - r NTIFY ALL THAT APPLY
Buyer 1 - Name as it appears on conveyance document Buyer 2 - Name a- p• ar on c• IV; a - . •cument
Patrick Driscoll Becky Driscoll •
' Address (number and street) Address (number and street)
Ali? 5 . Wnei 5+ .
City, State, and ZIP Code City, State, and ZIP Code 6
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Country Country
USA USA G(B opi,pf, .. ��d}
Email Address
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Pursuant to IC 6-1.1-12-44, the Sales Disclosure Form may be used to apply for certain deductions. Identify all of those that apply:
t YES NO CONDITION YES NO CONDITION
S O 1 . Will this property be the buyer's primary i' C 3. Homestead
residence? O PI 4. Solar Energy Heating or Cooling System
98 Er-
0 2. Does the buyer have a homestead to be vacated 0 O 5. Wind Power Device
for this residence? If yes, provide address 0 O 6. Hydroelectric Power Device
Address (number a d street) Q 7. Geothermal Energy Heating or Cooling Device
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N City, State, and ZIP Code County
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( Under penalties of perjury, I hereby certify that 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. (Note: Both spouse's
1 information, SSN/Driver's License/ID/Other Number is necessary only if a Homestead Deduction is being filed.)
(