Homestead_Cavazos 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. SELLER(S)/GRANTOR(S)
Sailer 1 -Name as it appears on co veyance document Seller 2-Name as appears on conveyan tt: went
Addre s Addressnumber and street number and treet) �� � ( I
-4,
City,state and ZIP Code City,state,and ZIP Code --6
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Country 0 5 A Country �rgSp ()
Nrirekenber
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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
rea property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Sig ature° Smeller / , n Signature of Seller
.Vt/6 r E. i c•V VJ ,
Pri ted Name of Sel -r i'=te signed(mm/ddlyyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Sidney E.S C : c-e,c i./30/2022
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
Christopher E. Cavazos Whitney M. Cavazos
Address(emptier andtreet) Address(amber and street)
GAK J it410 E. 18 /7 S II/ 0 F.
City,state,and ZIP Cod City,state,an ZIP Code
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Country U 5 i/I Country u c
•
YES NO CONDITION YES NO CON ION
O O 1.Will this property be the buyer's primary O 0 3. Homestead
residence? 0 O 4.Solar Energy Heating or Cooling System
0 ._ /2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
ld for this residence? If yes,provide address: O O 6. Hydroelectric Power Device
Address(number and street) 0 0 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county Q/ -)1,_1/i_'o i. _ b 00.
0. 960 - 006
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