Homestead_Greubel (4) H. PREPARER
Preparer of the Sales Disclosure Form Title
Megan Boger 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)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on rn^TEED
Casey D. Burton
Address(pumber ap 1 s et) ,( Address(number and street) ( /�
City, tate,and ZIP Code City,state,and ZIP Code OCT ei 1 LD� `�� )
Ef�. �y �2�2�
Country Country �L.L� iJ ._t`
US IVTY AU
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 transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
gnatu o Sellp{ Signature of Seller
/ /) ]yCC ��
Printe a�YSeller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Casey D. Burton 10/21/2022
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
Isabel E. Greubel
Address(number and street) Address(number and street)
210 South West Street
City,state,and ZIP Code City,state,and ZIP Code
Haubstadt, IN 47639
Country Country
US US
certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary O 0 3. Homestead
O O r 'dence? 0 O 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
O for this residence? If yes, provide address: 0 O 6. Hydroelectric Power Device
Address(number and street) O O 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county o 1 C, _ 19 - 31— O,-0Oc, , S,,/ _ ,a'
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
Last 5 of SSN:
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