Homestead_Walker H. PREPARER
Preparer of the Sates Disclosure Form Tale
Stacy Brown Settlement Agent
Company
Address(number and street city.state.country,and ZIP Code)
2301 N.Burkhardt Road,Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
MGfi--r- ‘...).1.)ci 1u,..k.1 .
Address(number and street) Address(number and street)
'30'7-E i-1-ftubSt I. The E- i+a-“.bs•r-
City,state,and ZIP Code City,state,and ZIP Code
}to ub s MA .—A-N `/'-7i. 3ci
Country Country
E-mail address
( )
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.
Signature( � of Seller // p J� Signature of Seller
/+'Y.r -Cud /v �A-`^`D Date signed(mmldd!
Printed Name of Seller 1 Date signed(mmfddlyyyy) Printed Name of Seller 9 yyyy)
t�tu4.4►K,W Lt].Wi,l)v_e,l 11/24/2021 11/24/2021
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
Matthew W.Walker Winter D.Walker
Address(number and street) Address(number and Street)
707 E.Haub St&709 E.Haub St. 707 E.Haub St.&709 E.Haub St.
City.state,and ZIP Code City.state,and ZIP Code
Haubstadt,IN 47639 Haubstadt,IN 47639
Country Country
US US
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 O CONDITION -E NO CONDITION
L7 r YES„rk 1-Will this property be the buyer
's primary E 0 3. Homestead
• residence? 0 0 4.Solar Energy Heating or Cooling System
2_Ones the buyer have a homestead to be vacated 0 eg 5•Wind Power Device
O i. for this residence?If yes,provide address: 0 0 6.Hydroelectric Power Device
Address(number and street) O gi 7. Geothermal Energy Heating or Cooling Device
City,state.and ZIP Code County 26-19-36-303-000.749-009
Under penalties of perjury,I hereby certify that 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