Homestead_Kitzinger Jr H. PREPARER
Preparer of the Sales Disclosure Form Title
Micah Scott Escrow Officer
Company
Address(number and street,city,state,country,and ZIP Code)
7412 Eagle Crest Blvd. Evansville, IN 47715
I.SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Austin J. Montgomery Alyssa M. Montgomery(f/k/a Alyssa M.Ybarra)
A (number_ and st�gt)in i r Jpi 3 rAd�r ss�pumber egret)K � / /�
City,s 2nn IP Code/ City, a (() Z �C/olddeV J ' _ /�r,�/ y'"� �/� Country //(V�G^J /Country U3
E-mail address
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.
ignature of Sel Ilex _ y ' naturept, a er /
Printed Nameof-, -.-1
S JeJll`ler l �/ � Date signed(mm/dd/yyyy) Pr ted Name(` of Sell Dat signed(mm/dd/yyyy)
Austin J. Montgomery 106/02/2022 Alyssa M. Montgomery 06/02/2022
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
Edward Alan Kitzinger, Jr. Nicole Kitzinger
Address(number a\nd st/� t) Address(number and street / ,,
n�73 `}DJ /lw�eGt.rL l n. 8-a-3 N5d /J4eu a `-
City,,,gate,and ZIP Code ' / / City,sjt te,and ZIP Cy e ,__� �j���
/L.1v��v(Lc �N Ll7�o /t�en,SU 'it,-, `7 i
Country Country V1 S
E-mail address A//A
apply for certain deductions.Identify ay of thos a I
YES NO CONDITION YES NO CONDITIO `'el
1.Will this property be the buyer's primary O 0 3. Hom� 1 2n
O 0 residence? 0 Cl 4.Solar En f tin or Coolie system
C c�
}, 2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power DPfil yr . U- , _ '1
O `NC)for this residence?If yes,provide address: 0 C) 6. H droelectric Power,-.�0, • b`-�J
Address(number and street) 0 O 7.Geothermal Energy He�atSRPCooling Device
City,state,ZIP code,and county thh 1.n - Q�1 _L�®`,l _ Dc l k <o.-0 f
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge( and belief,Is true,correct and complete
I , ,, ,r"
,
_y,. „`,4 �,4 F y.,- .t.
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