Homestead_Staggs (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Arnie Maslanka Escrow Officer
Company
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
Austin Oak Elmore Seller 2—Name as appears on conveyance document
Addrnu4tberantreet) - ,� � J
�.17 rt N Address(number and street)
City,state.p; T
odein • � 4-71 City,state,and ZIP Code
Country Country
United States of America United States of America
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 .roperty,or omits or falsifies any information required to be provided,commits a Level 5 felony.
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'}/� il
Seler Signature of Seller
3ff/�.L /
Printed Name of Seller T Datesyned(rot Jdd/yy+ry)^ Printed Name of Seller Date signed(mm/dd/yyyy)
Austin Oak Elmore I `� it '4 /V7a�«
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDEN, 1 THAT APPLY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as appears on conveyance cu nt
Tyler Staggs s
Address(number and street) Address(number and street) _ Fj0
-6
300 S.4th Ave �i 2,�.,
City,state,and ZIP Code City,state,and ZIP Code �''/4 �0<<'
Country Country Cb(/ti.I
United States of America United States of America '9( ;
eductions.Identify all of those that apply:
YES O CONDITION YES O CONDITION
0 1.Will this property be the buyer's primary residence? ❑ 3. Homestead
El 0 4. Solar Energy Heating or Cooling System
❑ Q 2.Does the buyer have a homestead to be vacated for ❑ 0 5.Wind Power Device
this residence? If yes, provide address: El 0 6. Hydroelectric Power Device
Address(number and street) ❑ El 7. Geothermal Energy Heating or Cooling Device
City.state,and ZIP Code County
26- 1CA—31-304 -000. g Cpt -coot _
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