Homestead_Buckman II H. PREPARER ,
Preparer of the Sales Disclosure Form Title
Christina Gourley Title Clerk
Company
Address(number end street, city,state,country, and ZIP Code)
4600 Washington Ave, Suite 102, Evansville, IN 47714
I. SELLER(S)/GRANTOR(S)
Seller 1 Name as it appears on conveyance document Seller 2—Name as appears on conve a
Estate of Mary Kaye Sloan F I
Address(numb and street) Address(number and street)
'77v`1 /uAd i , i—. Cce.,I1. Dc. - 4'G j
City,state,and ZiP Code City,state,and ZIP Code MAR L 1 'LULL
A L)(-11� 1 t d, 0 - 1'4/067
Country Country 'zu, UI/t -ro
GIB-ON rOUNTY AUDITOR
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 omits or falsifies any Information required to be provided,commits a Level 5 felony.
Signet tre of I r Signature of Seller
noted Nam ' eller Date signed(mm/dd/yyyy) Printed Name of Seller ' Date signed(mm/dd/yyyy)
Sheralynn loan O zW,•?6,-49--- _
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1—Name as it appears on conveyance document I Buyer 2—Name as it appears on conveyance document
Anthony Joseph Buckman, II Katie Poole
Address(number and street) Address(number and street)
2L1t C- LC P n 5e? 7)-7e
�� jst,,y,state,and ZIP Code City,state,and ZIP Code
ni (7{`C/)C �
c ti C_r L) -7 ,70
o Country Country U
' E-mail address- '
90 Pursuant to IC 6-1.1-12-14,the Sales Disclosure Form may be used to pply for certain deductions.identify all of those that apply:
t YES NO CONDITION YES NO NO CONDITION
• p d o 1. Will this property be the buyer's primary , y 0 3. Homestead
O residence? 0 l J 4.Solar Energy Heating or Cooling System
I 0 Q 5. Wind Power Device
M cy2. Does the buyer have a homestead to be vacated
H for this residence? If yes, provide address: p C) 6. Hydroelectric Power Device
Address(number and street) r l 9r 0 p 7. Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
-= r/J(r:c J s' L 7 D4 -\2-OS - 2-0y- (!) e)o- 30'\-02.8 -
�v Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
r-6 as required by law,and Is prepared In accordance with IC 6-1.15.5.A person who knowingly and intentionally falsifies the value of
,), ,
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