Homestead_Bichler III H. PREPARER
Preparer of the Sales Disclosure Form Title
Christina Gourley Title Clerk
Company
Address(number and street,city,state,country,and ZIP Code)
4600 Washington Ave, Suite 102, Evansville, IN 47714
I. SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on veyance document
Logan D. Firkins
Address(number and street) Address(number and street) 7
`10 9 t 7etteS•t-
City,state,and ZIP Code City,state,and ZIP Code "4
Country Country -'j ` le .,_
•
E-mail address mail address '.dtV � � ,Telephone number
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is trO cS j -t nd complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and Intentionally falsifid d value of transferred
real property,or omits or falsifies any Information required to be provided,commits a Level 5 felony.
Signs u of Seller Signature of Seller
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/ddlyyyy)
Logan D. Firkins
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
Joseph A. Bichler, III
Address(number and street) Address(number and street)
Io/V liar,(3Yrcc1�
City,state,and ZIP Code City,state,and ZIP Code
Princcfon :-/7(0 70
Country Country
E-mail address
( )
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:
YES NO CONDITION 7- NO CONDITION
1.Will this property be the buyer's primary 0 3. Homestead
residence? O O 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
for this residence? If yes,provide address: O p 6.Hydroelectric Power Device
Address(number and street) O p 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
^t2- 01-- 10 -003. 28 8- 024?-
' 4
{
�. r.