Homestead_Huey H. PREPARER
Preparer of the Sales Disclosure Form Title
Christa D. Tracey Escrow Officer
Company
Address (number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document Seller 2 - Name as it appears on conveyance document
Anna M Huey
Address (number and street) Address (number and stre
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City, State and ZIP Code City, State and ZIP Code
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Country Country see
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Email Address
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Under penalties of perjury. I hereby certify this Sales Disclosure, to the best of my knowledge ann •; trruue�e``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 fa flue of transferred real property, or
omits or falsifies any information required to be provided, commits a Level 5 felony.
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Sign re of Seller Signature of Seller �TQR
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Printed Name of Seller Li Date Signed (mm/dd/ ' Printed Name of Seller Date Signed (mm/dd/yyyy)
Anna M Huey YYYY) r—
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
Anna M. Huey
Address (number and street) Address (number and street)
106 N Church St
City. State and ZIP Code City, State and ZIP Code
Owensville. IN 47665
Country Country
United States of America
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:
YES/ NO CONDITION YES NO CONDITION %a/0142k
❑ 1. Will this property be the buyer's primaryresidence? ❑ 3. Homestead
P P Y Y
❑ L1 2. Does the buyer have a homestead to be vacated for ❑ • Solar Energy Heating or Cooling System
residence? If ❑ d 5. Wind Power Device
this esidence . yes, provide address: e
Address (number and street) ❑ � Hydroelectric Power Device
❑ 7. Geothermal EnergyHeatingor CoolingDevice
City, State, and ZIP Code County
r@. 12-201 —0 00 I ? - 022
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
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