Homestead_Menke (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Haley Smith Escrow Officer
Company
Address(number and street,city,state,country,and ZIP Code)
7412 Eagle Crest Blvd Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Kevin P. Menke Christina M. Menke
Address(number and street) Address(number and street)
702 North Roosevelt Drive 7805 South 10 East
City,state,and ZIP Code City,state,and ZIP Code
Fort Branch, IN 47648 Fort Branch, IN 47648
Country CountryUS
US
E-
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,
Sign re f Seller �_ Sign3tRr of 4Iler
` /k ,t—
H.
Printed Name of Seller Date signed(mm/ddlyyyy) Printed Name of Seller Doke signed(mm/dd/yyyy)
Kevin P. Menke 1',,10le�aoa( Christina M. Menke id-13-3ON
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
Christina Menke Doris Y.Stolz
Address(number and street) Address(number and street)
7805 South 10 East 7805 South 10 East
City,state,and ZIP Code City,state,and ZIP Code
Fort Branch, IN 47648 Fort Branch, IN 47648
Country Country
US US
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary 0 0 3. Homestead
O 0 residence? 0 O 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0_ O 5.Wind Power Device
0 for this residence?If yes,provide address: 0 O 6. Hydroelectric Power Device
Address(number and street) 0 O 7.Geothermal Energy Heating or Cooling !Device
City,state,ZIP code,and county a(„`t'J�_.. l 1 .. e 3 _ out .�Z--o 26
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
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