Homestead_Ruether H. PREPARER
Preparer of the Sales Disclosure Form 1 Title
Settlem
ent
_Amanda Daly ------- --- --- -
Address(number and street, city,state,country.and ZIP Code)
7820 Eagle Crest Blvd,Suite 201,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
Jerry Robert Wallis Nikki Jo Wallis
Address(number and street) Address(number and street)
2720 E SR 64 _ 2720 E SR 64
City.stale.and ZIP Code City,state.and ZIP Code
Princeton,IN 47670 Princeton,IN 47670
^
Country Country
US US
(
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 accord nce with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred
real prop.` y,or omits or falsifies any f mation required to be provided,commits a Level 5 felony.
Signature f Seller Sig a ure of Sel
Print-lam, of Seller Date signed(mm/dd/yyyy) Printed Na of Seller Date signed(mmfdd/yyyy)
Jerry 'ob= Wallis L_05/26/2022 Nikki Jo Wallis 1 05/26/2022
J. BUYER(S)IGRANTEE(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 ie nceEm
William Ruether J
Address (number and street) Address(number and street)
500 S Willard Street tiAPX- _
City.state,and ZIP Code ! City,slate,and ZIP Code
Fort Branch,IN 47648 l __
Country Country . N COUNTY AUD
US C,►BSO
( ? _m_
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions_Identify all of those that apply: 1
YES NO CONDITION 4_ NO CONDITION
.)6
1.Will this property be the buyer's primary 0 3. Homestead
residence? p (c 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 Q 5. Wind Power Device
for this residence?If yes,provide address: 0 Q 6. Hydroelectric Power Device
Address number and street) 0 (g 7.Geothermal Energy Heating or Cooling Device
City.slate.ZIP code.and county
6-ta--fq-t01-000 . 67g - 02.6
5 C OPY