Homestead_Gipson H. PREPARER
Preparer of the Sales Disclosure Form Title
Christina Latham Title Clerk
Company
Address(number and street,city,state,country,and ZIP Code)
4600 Washington Ave,Suit 102 Evansville,IN 47714
I. SELLER(S)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyance docu
Sire Holdings LLC
Address(number and street) Address(number and street)
3`/R• E 7` v .
City,state,and ZIP Code City,state,and ZIP Code
Fiat?T 3rom IL° l-, 'Ai I/7.1� 1
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 omit or falsifies any information required to be provided,commits a Level 5 felony.
Signat f altar Signature of Seller
Print .Name of Seller
Dat 7.4 Printed Name of Seller Date signed(mm/dd/yyyy)
zei
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROP RTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1 -Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
Richard Kyle Gipson Brittany Marie Gipson
Address(number and street) Address(number and street)
7 e Sin C(ctI r 4- cirytR..
City,state,and ZIP Code City,state,and ZIP Code
- r4- .Brcir c.,h , .) q 7Cv /X
Country in Country
E-mail address '
apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES, NO CONDITION C)
. c ❑ 1. Will this property be the buyer's primary �•r��"�/ 0 3. Homestead Q 0
3. residence? 0 x 4. Solar Energy Heating or Cooling Sys a' tzi
01 c, 0 2. Does the buyer have a homestead to be vacated ❑ x 5.Wind Power Device co Hi
i 1 for this residence? If yes,provide address: ❑ x 6. Hydroelectric Power Device N tsj
�...y
V
c ; Address(number and street). 0 x 7. Geothermal Energy Heating or Cooli� ice
2, -C 9i( dt./ IA) (h yard
0
Q r�-4 City,state,and ZIP Code County 26 19-18-302-000.364-026
Ou ^Svl lLc l m
,C h� �#7 fob "
73
`� 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