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Homestead_Moody (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 Lisa L. Moody Addre�§(ry{xnbe�and street t � r ��Q �/ Address(number and street) City,ssttaate✓ag/dZIZIP Code V v 1 City,state,and ZIP Code ,t/ 5 V((l- , ..���77/� Country Country US US E-mail address 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 re uired to be provided,commits a Level 5 felony. Signature elfeT 1 Signature of Seller r/ S Printed Name of Seller Date signed m/dd/yyyy) Printed Name of Seller hats i•,•r•d(mm/dd/yyyy) Lisa L. Moody 3 h'2'7j ' J. BUYER(S)/GRANTEE(S) —APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALA/THAT A` Y Buyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appears on conveya/n oeuent Dale W. Moody // Address(number and street) Address(number and street)U'/QS J� 10851 East 700 South OA,'Co 2 '/ City,state,and ZIP Code City,state,and ZIP Code 4/1/41� Oakland City, IN 47660 qv© . ..Q(-- „,„\ Country Country /rOR US US apply for certain deductions.Identify all of those that apply: YES NO CONDITION YES NO CONDITION D ❑ 1.Will this property be the buyer's primary C) ❑ 3. Homestead residence? ❑ (] 4.Solar Energy Heating or Cooling System ❑ v 2. Does the buyer have a homestead to be vacated ❑ O 5.Wind Power Device for this residence? If yes, provide address: ❑ 0 6. Hydroelectric Power Device Address(number and street) ❑ Q 7. Geothermal Energy Heating or Cooling Device City,state,ZIP code,and county ` .3/ — 'aI?_2Do-( z. (Fj_GO rf