Homestead_Walker H. PREPARER
Preparer of the Sales Disclosure Form Tide
Tas /
Tasha Garcia-StarksAS'c�-,C (��(},�►tf
Company E-mail address
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
_ Keith A.Messick Cindy Messick
ddress(number and sir t)
Ilj _ Address(numb ., n 7treet) .7„...e._
City,state,ttand ZIP Cod J
Oi &0t h. C1t ,( l�/f City,state,and ZIP C
Country f Country
United States of America
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,comm)ts a Level 5 felony.
S/$/ a z S ler ALs,vice JJ Sig aim of SJel ler //1
Printed Name of Seller D e i ( d ) Printed Name oflSeller Date signQd m! y)
Keith A.Messick I1 i Cindy Messick 1 — t
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
Emily Marie Walker
Address(number and street) Address(number and street)
1897 S.Lakewood Circle
City,state,and ZIP Code City,state, IP Code
•
Francisco,IN 47649
Country Country
United States of America United States of America
YES NO CONDITION ryffl5 CONDITION 63
0 1.Will this property be the buyers primary residence? 0 3.Homestead o m
0 D 4.Solar Energy Heating or Cooling Sys Z c
❑ �2.Does the buyer have a homestead to be vacated for 0 —E/ 5.Wind Power Device z - o
this residence?If yes,provide address: 0 L7 6.Hydroelectric Power Device A iv
VI
Address(number and street) 0 7.Geothermal Energy Heating or Coolirll vice d
City,state,and ZIP Code County 26-13-20-200-001.504-004 0
4° F-
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