Homestead_McVaigh H. PREPARER
Title
Preparer of the Sales Disclosure Form Closing Title Agent
Candace Rogers
Address(number and street,city,state, country, and ZIP Code)
4905 Theater Drive, Evansville, IN 47715
I. SELLERS)/GRANTOR(S) on conveyance document
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appearsEstate of Carol E. Linxwiler
Estate of Carol E. Linxwiler Address(number and street
Address(number and street) * (._._ du. t 1
City,state,and ZIP Code C'ty,state,an. ZIP Code
0(0 kj R vac e -, ) .�A--/ Li-1 (o L�
D - Country
Country USA
USA `
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,commitur ts a Level 5 felony.
.nature of l /� �Q ,� ,� ��..
r''/„ PA i0/2/1-1240/vV-Ikre te Date signed(mm/dd/yyyy)
ate signed(mm/cid/yyyy) Printed me Seller
y: a Name f Sel� By:Dale P.Young,Personal Representative 17/20/2022
By:Sandra R.Boling,Personal Representative 7/20/2022
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
appears on conveyance document Buyer 2-Name as it appears on conveyance document
Buyer 1-Name as it F ILEA
John Dale(number
McVaigh
treet) Address(number and street)
702Add
rSo(number and set
South Hall Street City,state,and ZIP Code JUL 2 5 2022
City,state,and ZIP Code
Princeton, IN 47670 Country ` )
Country /, �-erliellteilahtieD=17er. r�
to apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
O 0 3.Homestead
1.Will this property be the buyer's primary II O residence? 0 04.Solar Energy Heating or Cooling System
p p 5.Wind Power Device
2. Does the buyer have a homestead to be vacated 0 1J 6. Hydroelectric Power Device
O for this residence? If yes, provide address:
Address(number and street) 0 Q 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county -X Z - 01-3 03 - 000. IA3 5-_0 2 e
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the 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
Note:Both spouse's
transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
information,SSN/Driver's License/ID/Other Number is necessary if a Homestead Signature of Buyer n2/is b ing filed.)
.
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