Homestead_McCandless H. PREPARER
Preparer of the Sates Disclosure Form Title
Stacey Salzman Settlement Agent
Company
Address(number and street,city,state,country,and ZIP Code)
2301 N.Burkhardt Road,Evansville,IN 47715
,
1. SELLER(S)/GRANTOOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on Conveyance document
Sonny Gregory
Address(number end street) Address(number and street)
6609 S SR 57
City,state,and ZIP Code City,state,and ZIP Code
Oakland City,IN 47660
Country Country
US
E-mail address
my knowledge and belief,is true,correct and complete as
required by law,and Is prepared In accordance with IC 6-1.14.5.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.
S' alur Seller ,- "- Signature of Seller
Printed Namf$eller Date signed(mm/ddlyyyy) Printed Name of Seller Date signed(mm/ddlyyyy)
Sonny Gregory 12/10/2021 12/10/2021
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
Chet A.McCandless
A dre s(nuunrynnb{er arrt steel)( �. t r-1 Address(number and street)
Ci , tate.and ZIP Code - City, - -
i ( ty,stale,and ZIP Coda
C ,\,(±4,_[`,..f\, ( % ` \ t)k(-"
Country t Country
apply for certain deductions.Identify all of those that apit)r:
YES NO CONDITION YES NO CONDITION W
® primary 0'1.Will this property be the buyer's 0 3.Homestead z p
residence? O (X 4.Solar Energy Heating or Cooling Syet r' H
0
® 2.Does the buyer have a homestead to be vacated 0 i 5.Wind Power Device z N rl
for this residence?If yes,provide address: 0 � 6.Hydroelectric Power Device y�
Address(number and street) 0 ® 7.Geothermal Energy Heating or Cool ce ell
-I ..
City,stele,and ZIP Code County na
26-20-14-100-001.717-001 c>
at
3