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<br /> <br />Buyws' lost name(sI. first, middle initial <br /> <br />9D.rthLliN af t~Cft\h l\e l. L C. <br /> <br /> <br />PE-20 <br /> <br />. _oIdood",,,,,,_ <br /> <br />q!31 er-=r <br />Financial .............. <br />. T.... f"I"'h- price <br />.04~ ($OO~~ <br /> <br />t<y? . ~.Ob <br />. Po;... '" ...-"';- paKI by ... <br /> <br />. Type tI!~ (check aU that apply) <br />o ~~rwlarMlor 0 ~ invotv.dthtltrodeof <br />o Property II a gift or Inheritonce 0 =1=igiOUIOfChOritab&e <br /> <br />~me phone <br />PINe> G!V/(. ~ ~ <br />~1u.c:.MN 'SS/f; . '-190 ~ zzoo <br />. ~':,\j;t\e.. Rt1 Cou.~ <br /> <br />1ogaI...."pIIoool_~(1oI,biod<GOdp/at,"'_3_0I...logaidoocri.....1 ~ <br /> <br />~Le rxh~~ <br />~~=,::r:~~1U':7':~..:.=~lfyel. OYM Dna <br /> <br />s.tIerl' Ia. namell). first. middle initial <br /> <br />~oo ~)\\P.l <br />StNet rural route of propetty purchased <br /> <br />L-- <br />L-- <br /> <br />L- <br /> <br />TotaIpo<19OOI_ <br />.........Iueo <br /> <br />.$ <br /> <br />o auy.riIGunilof~ <br />O condecnnatlon Of fonclolUre <br />..- <br />o PoyoII"'......of_ <br /> <br />o ~.=..1!: ~~)name <br />o ..,. pu........! ...... ;_..~ <br />o =~=-~~_Iwo <br /> <br />. Type tI praperty transfened (check aH that apply! <br />~ Im>d only 0 Laod GOd buildl.... 0 ~~~;:.~~ <br /> <br />~ Planned .... tI praperty (check -t <br />~....- ."".famlly ,,,,,,""'_01" ""'_boIow, ""'_-............ PE-_...._ ~..thio_. <br />~ a._I dupIu, "pie>< 0 =:1......, 0 1i;;:":rbu,:".::'al <br />Cabi.",...-I 0 ~buildl"" - 0 <br />1__1011 _ l""mb.oI"',,1 _ 0Ih0< (doocribool <br /> <br />will thll property be the buyer'1 pri~i~ midence'O}lel ~ <br /> <br />MeIhacI tI financing (cOmpI.I. GIlly If ..a.Mi.....-l. including a contract for deed or .......... mortgage) <br />~~ ~~Iordeed ~..:. =%t ;r'~ <br />-"'- <br />.0 0 <br />.0 0 <br /> <br />Dale cI 0Ir'/ lump 111m <br />(baIaonI_ <br /> <br /> <br />"- <br />""9()-Z~1 <br />.......,~idlllllfidant <br /> <br />.... <br />f'/~ , <br /> <br />___a <br /> <br />tIC <br /> <br />... ... <br /> <br />tOo <br /> <br />"'" <br /> <br /> <br />fM <br /> <br />"" <br /> <br />NN <br /> <br />NN <br /> <br />SIockNo.6()C)(WOO <br />;".1/951 <br /> <br />.......__ ,.. 0 ~ 0 <br />DEPAR'MNT f:F REVENJE rlJ'V - 283211 <br /> <br />---...-.--- <br /> <br />. Wan. 5aciaIs-riIy..........1or _.. r.IoraI LD, IIUOIiIonI <br /><: tit - (b()OiB4"f .) <br />2 <br /> <br />. __SodaI......,.""-'''''- .........LD_.....a.onI <br />1 <br /> <br />2 <br /> <br />3 <br />5kIck....6OQ().WO <br />"",7/951 <br /> <br />3 <br /> <br />DEPARTMENT f:F REVENUE rn'V <br /> <br />'283211 <br />