Homestead_Cowling ..---'?''''----
-„,.-APARER
--Preparer of the Sales Disclosure Form Title
-
Christa D. Gibbs Escrow Officer
Company
Address(number and street,city, state,country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713 ,
I. SELLER(S)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as it appears on conveyance document
Chad D. Cundiff Ip - 42.4.13 U5.-tak.,,()-(- -k---\-G-,..CLivxat-Ct Kristen J. Dicus R_,- ve Z. 4e-cte c4 1:14,-, cu,d,r1
Address(number and street) Address(number and strQet)
1 ,---1 - - V`-) -.- -‘‘-f- A42--' ce---d •=1'- ----1 Yi 1---1 0 ecie-ilh el-5
City,State and ZIP Code City, State(Rnd ZIP Code
IN C)V We -3.,,,) (--k--)S G Lf , IN rf I 1,1.C...-e-4D -,
Country Country
United States of America United States of America
E-mail address s
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,commits a Level 5 felony.
Signer ) , 6, , kainnoif Sillet2„4/az
f Ul., sap Pcv IL
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Nameof Seller 1ate signed(mm/dd/yyyy)
Chad D. Cundiff / I - ". - -.. ._J Kristen J. Dicus i /-c)--eA --,4-- I
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 conve ance document
Clara E. Cowling ED .
Address(number and street) Address(number and street)
512 W. Mulberry Street
City, State and ZIP Code City, State and ZIP Code NOV 2 4 2021
Princeton, IN 47670 ,
Country ' Country Vhccize,z, C:i.,. ,./.444..e.c,n4..)
United States of America GIBSON COUNTY AUDITOR
E-mail address
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions. Identify all of those that apply:
YES NO CONDITION YE .' NO CONDITION
0 1. Will this property be the buyer's primary residence? (:],e,-3. Homestead
0 ir tE_ z4. Solar Energy Heating or Cooling System
0 C2/2. Does the buyer have a homestead to be vacated for 0 da,r 5. Wind Power Device
this residence? If yes, provide address:
0 y.,7 Hydroelectric Power Device
Address(number and street) 0 7. Geothermal Energy Heating or Cooling Device
City, State,and ZIP Code County c26 - R - 11 — )0/- 000. Lig - /),?Es.