HomeMy WebLinkAboutHomestead_HainesH.PREPARER
Preparer of the Sales Disclosure Form
Title
Taylor M. Millsap
Attorney
Company
Email Address
Telephone Number
Team Black Law, P.C.
tmillsap@teamblacklaw.com
(812 ) 4074311
Address (number and street, city, state, country, and ZIP Code)
302 E. Main Street, Francisco, Indiana, USA, 47649
I. SELLER(S)iGRANTOR(S) -
Seller 1 - Name as it appears on conveyance document
Seller 2 - Name as ap c vey ent
Alan B. Haines
Address (number and street)
Address (number and street)
1307 S. 1050 E.
City, State, and ZIP Code
City, State, and ZIP Cod
$ 2�2�
Oakland City, Indiana 47660
Country
Country
USA
Email Address
Telephone Number
Email AddressGI SON COUNTY
Tele hone Number
n/a
(812 ) 644-8101
q
)
Under penalties of perjury, I hereby certify this Sales Disclosure, to the best of my knowledge andbelief; Is true, co ect, 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 falslfies any Information required to be provided, commits a Level 5 felony.
Signet u o eiler
is
Signature of Seller
.
Printed Name of Seller
Date Signed (mm/ddlyyyy)
Printed Name of Seller
Date Signed (mm/dd/yyyy)
Alan B. Haines
06l08/2026
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 appears on conveyance document
Sondra Ross Haines
Alan B. Haines
Address (number and street)
Address (number and street)
1307 S. 1050 E.
1307 S. 1050 E.
City, State, and ZIP Coda
City, State, and ZIP Code
Oakland City, Indiana 47660
Oakland City, Indiana 47660
Country
Country
USA
USA
Email Address
Telephone Number
Email Address
Telephone Number
Sondrahaines@yahoo.com
(812 ) 644-0117
n/a
(812 ) 664-8101
Pursuant to IC 6-1.1-12- 4, the Sales Disclosure Form may be used to apply for certain deductions. Identify all of those that apply:
YES NO CONDITION
YES NO CONDITION
1. Will this property be the buyer's primary
D O 3. Homestead
residence?
O D 4. Solar Energy Heating or Cooling System
O O 5. Wind Power Device
2. Does the buyer have a homestead to be vacated
O O for this residence? If yes, provide address:
O p 6. Hydroelectric Power Device
O D 7. Geothermal Energy Heating or Cooling Device
Address (number and street)
t�� -1 _ 1 �� - LI - �C ` , ,�% - ocx_o
City, Slate, and ZIP Code County
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 6-1.1-6.5-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/iDlOilher Number is necessary only if a Homestead Deduction is being flied):
ature o Buyer
Q=��\ nb�
Sign cf Buyer 2/Spouse
Printed Legal Name of Buyer 1 Sign Date (MM/DD/YY)
Printed Legal Name of Buy Spouse Sign Date (MM/DD/YY)
Sondra Ross Haines 06/08/2026
Alan B. Haines 06/08/2026
Last 5 Digits of Buyer 1 SSN/Drivees License/iD/other Number
Last 5 Digits of Buyer 2/Spouse SSN/Drivees LicensellD/Other Number
SSN: 61697
1 SSN; 22935
Page 3