Homestead_Davis (6) H. PREPARER - - -- - — -- - -
Preparer of the Sales Disclosure Form Title
Selena Pressley Title Clerk
Company
Address(number and street,city,state,country,and ZIP Code)
7820 Eagle Crest Blvd, Suite 201, Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Andrew R. Davis
Address(number and street), �j Address(number and street)
dr8(j f 1,'Ite " /
City,State,and ZIP Code City,State,and ZIP Code
_/1/0t. ihoVk (/1 t/7G'
Country Country
U.S.A
Email Address
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.
Signature of Seller Signature of Seller
Printe ame of Seller � Date Signed(mrn/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Andrew R. Davis (, -2$-�po7y
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDE THAT APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears con y ce d u
Staci A. Davis
Ad ss(number nd str t) Address(number and street) �l'Q \
Ci ate,an IP Code/. / / y / �/ City,State,and ZIP Code 2024
/r-/ k rkti G,l /r v 2- ! 6,,./4 �fj 7
Country Country � �
U.S.A G/BSCN Cp CO, j
for certain deductions.Identify all of those that apply:
YES NO CONDITION ES ANO CONDITION
O 1.Will this property be the buyer's primary O 3. Homestead
residence? 0 4.Solar Energy Heating or Cooling System
O 2.Does the buyer have a homestead to be vacated 0 . 5.Wind Power Device
for this residence? If yes,provide address: 0 6. Hydroelectric Power Device
Address(number and street) 0 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County
2� -1 C 1q —103---601- 191 -- o'2 .