Homestead_Long H. PREPARER
Preparer of the Sales Disclosure Form Title
EMILY TEVAULT , LOAN PROCESSOR
Company
Address(number and street,city,state,country,and ZIP Code)
PO BOX 126 LYNNVILLE. IN 47619
I. SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
ESTATE OF EDNA K AUSTILL
Address(number and street) Address(number and street)
12810 BATAAN LANE
City,state,and ZIP Code City,state,and ZIP Code
EVANSVILLE.IN 47725
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 nd of transferred
real property,or omits or falsifies any Information required to be provided,commits a Level 5 felony.
Signature of Seller Signature of Seller
ct an
Printed Namb bf Sel r Date signed(mm/dd/yyyy) Printed Name of Seller Date sign m/d )
ESTATE OF EDNA K AUSTILL 12/01/2021 F�
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDEN4 L THAT frytfLY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on cony ce..riacumentc''7
JEFFERY LONG MELISSA LONG Cesr--�'. . -
Address(number and street) Address(number and street) 9
120 N RED BANK RD 120 N RED BANK RD '&,
City,state,and ZIP Code City,state,and ZIP Code 1O1,
EVANSVILLE.IN 47712 EVANSVILLE. IN 47712
Country Country
E-mail address
YES NO CONDITION YES NO CONDITION
0 ❑ 1.Will this property be the buyer's primary El ❑ 3.Homestead
residence? IEI C]✓ 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated ❑ E✓ 5.Wind Power Device
CI El for this residence?If yes,provide address:
0 �✓ 6.Hydroelectric Power Device
Address(number and street) 0 ID 7.Geothermal Energy Heating or Cooling Device
City,state,and ZIP Code County 26-2 1_3 2 -3
03 ^ O .5 1 0-00I
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