Homestead_Buedel •
H. PREPARER
Preparer of the bsure orm A Title��&
Escrow Officer
Company
i
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 conveyan doc e
Rita S.Thompson
Address(number and street)
{ �f f a. s . ( ' it i f�, a. Address(number and street) d(J 9
City, 1 end ZIP C rirryx `-u""^.*-/r !►" , 1-1-1(l!O City,state.and ZIP Code CiecOH e�� ZOe
i Country Country CO N 4,,,
United States of America United States of America V rY VDirO
E-mail address
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.
-`fir,°"
• 1. J ' of Seller
5. --0),,',��' Signature- -- __
Printed Name of Seller Date signed ] Printed Name of Seller ! Date signed(mm/dd/yyyy)
Rita S.Thompson eg ( O �
J. BUYER(S)/GRANTEE(S)—APPLICATION OR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY _
Buyer 1-Name as It appears on conveyance document Buyer 2-Name as appears on conveyance document
Donald William Buedel
Address(number and street) Address(number and street)
406 South Hudson Road
—
City,state,and ZIP Code City,state,and ZIP Code
Patoka,IN 47666
Country Country
United States of America j United States of America
deductions.identify all of those that apply:
YES NO CONDITION YES NO CONDITION
/
L� CI 3. Homestead
In- ❑ 1.Will this property be the buyer's primary residence? 0 El 4. Solar Energy Heating or Cooling System
la i 2.Does the buyer have a homestead to be vacated for ❑ El 5.Wind Power Device
this residence? If yes, provide address: ❑ 121 6. Hydroelectric Power Device
Address(number and street) ❑ 0 7.Geothermal Energy Heating or Cooling Device
City,state,and ZIP Code ---_-_- County 2 C-O 4 -Z S-- o o - 000. 618 - 0 .