Homestead_Conrad H. PREPARER
Preparer of the Sales Disclosure Form I T
lle
Gwyn Shaw i Escrow Officer
Company
Address(number and street.city,state,country.and ZIP Code)
5231 Oak Grove Road,Suite A,Evansville,IN 47715
I SELLERS)/GRANTOR(S)
Seiler 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Christopher Michael Harmon Alicia Harmon
Address(number and street) Address(number and street)
5431 E.575 S. 5431 E.575 S.
City,state,and ZIP Code City,state,and ZIP Code
Fort Branch,IN 47648 Fort Branch,IN 47648
Country Country
United States of America United States of America
complete as
required bylaw.and is prepared In accordance with 1C 6-1.1Z A.A person who knowingly and lirlikeintienally falsifies the value of transferred
real property,or omits or falsifies:any lnfOrmatlo_ 6 required to becprovidedi commits a Level 5 felony.
Signature of Seller Signature of Seller
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Christopher Michael Harmon Alicia Harmon
•
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 appears on conveyance �r�
Austin J.Conrad _ a y J
Address(number and street) Address(number and street) Z Z
833 N.West Dr C
City,state,and ZIP Code City,state,and ZIP Code
Oakland City,IN 47660 - �1 otri
Country Country N
United States of America United States of America ,,,
E-mail address
Pursuant-to IC 64.1-1244,the Sales Disclosure Form may be used to applyfor<.prtaln deductions..Identify all of those that apply:
YES NO CONDITION YES NO CONDmON
0 0 3.Homestead
0 0 1.Will this property be the buyers primary residence? 0 0 4.Solar Energy Heating or Cooling System
❑ ® 2.Does the buyer have a homestead to be vacated for 0 0 5.Wind Power Device
this residence?If yes,provide address: 0 0 6.Hydroelectric Power Device
Address(number and street) 0 0 7.Geothermal Energy Heating or Cooling Device
City.state,and ZIP Code County
f 6-\k-i- IS -v0a- ono . 12\ - oo7
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