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Homestead_Menke (4) H. PREPARER Preparer of the Sales Disclosure Form Title Abbey Moore Closing Agent Company Address(number and street,city,state,country,and ZIP Code) 4905 Theater Drive, Evansville, IN 47715 I. SELLER(S)/GRANTOR(S) _ Seller 1—Name as it appears on conveyance document Seller 2—Name as appears n conveyance document Caleb Steven Menke Address(number and street) Address(number and st t) l4/L/e)/tg;6./04ic;cr Rd *"6. 40,0 City,State,and ZIP Code City,State,and ZIP Code �rnsville N1 7�LI) _ Country Country Is' USA c/ ' 10,E best of my knowledge 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 inte Isifies the value of transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. OR Signature of S?ller / Signature of Seller Crae---- Printed Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy) Caleb Steven Menke .. a L\ 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 Madeline Menke Address(number and street) Address(number and street) 11578 South 150 West City,State,and ZIP Code City,State,and ZIP Code Haubstadt, IN 47639 Country Country USA apply for certain deductions.Identify all of those that apply: YES NO CONDITION YES NO CONDITION 1.Will this property be the buyer's primary ] 0 3. Homestead d❑ residence? ❑ 17 4.Solar Energy Heating or Cooling System ���((( 2. Does the buyer have a homestead to be vacated ❑ 5.Wind Power Device for this residence? If yes, provide address: ❑ 1j 6.Hydroelectric Power Device Address(number and street) ❑ 7.Geothermal Energy Heating or Cooling Device City,State,ZIP code,and County b^ZZ (2 30o — 00 Z-(O1 —024- Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number Page 3 `t