Homestead_Holmes (3) H. PREPARER
Preparer of the Sales Disclosure Form Title
Lana Harper
Company
Address(number and street,city,state,country,and ZIP Code)
5231 Oak Grove Road,Suite A,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
Daniel A.Moon Jillian C.Moon
/ _
Address(number and street)
< b ( Cs rt�� c, , Address(number and street) Sjr3 CPR 4\-
e
i o
Clty,state,
� cs-\- jC0.rL, `1vW'7 I O City,state,and ZIP Code cl-pM �G� _�
11 lici LAR�
Country Country ,1
United States of America
'nature of. ller SI nature rSet
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Printed Name of Seller D)7Ie signed(m /ddtyyyy) Printed N of Seller Date signed(mm/dd/yyyy)
Daniel A.Moon n) 2l0 ( �o2t Jlllian Ct oon
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 appears on conveyance document
Christopher Holmes I
Address(number and street) Address(number and street)
405 S.Seminary Street
City,state,and ZIP Code City,state,and ZIP Code
Princeton,IN 47670
Country
certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION O L.
X 0 1.Will this property be the buyer's primary residence? ! 171
❑ 3.Homestead o N H
El 4.Solar Energy Heating or Cooling Systz -4 r
❑ �,/ 2.Does the buyer have a homestead to be vacated for El 5.Wind Power Device N
J"� this residence?If yes, provide address: ❑ 6. Hydroelectric Power Device
Address(number and street) ❑ 7.Geothermal Energy Heating or Coolince
xi
City,state,and ZIP Code County i
{ 26-12-07-401-001.530-028 W