Homestead_Bradfield H. PREPARER Preparer of the Sales Disclosure Form i Title
Gwyn Shaw Escrow Officer
Company ,
Address(number and street,city,state,country,and ZIP Code)
5231 Oak Grove Road,Suite A,Evansville.IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Robert Lee Sumner Gem Ellen Sumner
Apdress(number and stttypnet) tl
!(' 31/7 5 [/ 1 I_ mil,�,„�FcJ -f] Address(number and street) 5 r��
City_�,,5tate,and ZIP Cpdf e T I'] /�" �7
A.f Y,n 5U1/t o__ /7 i 7 7/ L/ City,state,and ZIP Code
Country ' ` Country
United States of America United States of America
E-mail address
who knowingly and Intentionally falsifies the value of transferred
real property,or omits or falsifies any Information required to be provided commits a Level S felony.
.6ignaty�;r Iler Qignatu ' Seller
f� /C,r '� -,9....,,.4 :1 nisi 4
;1.,,..ry 1,.IN
Printed Name of Seller Date signed(mm/ddlyyyy) t Printed ame of Seller Date/sig�n7ed m/dd )
Robert Lee Sumner i i..,7f 7/ 2_./ [ Gerri Ellen Sumner •'/4 7 (
J. BUYER(S)IGRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL TN T APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as appears on conveyance document
Dennis Bradfield
Address(number and street) Address(number and street)
4372 East 550 South
City,state,and ZP Code City,state,and ZIP Code
Fort Branch,IN 47648
Country Country
United States of America United States of America
E-mail address
for certain deductions.Identify all of those that apply:
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YES NO CONDITION YES NO CONDITION 47.4 00 ❑ 3.Homestead 20 ❑ 1.Will this property be the buyer's primary residence? 0 0 4.Solar Energy Heating or Cooling S I—I
❑ 0
2.Does the buyer have a homestead to be vacated for El 0 its
5.Wind Power Device iv
this residence?If yes, provide address: 0 0 6.Hydroelectric Power Device c
Address(number and street) 0 0 7.Geothermal Energy Heating or Cool, 'ce
O
City,Mate,and ZIP Code County
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26-19-02-400-000.608-025 Ci
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