Homestead_Carter (11) 1H. PREPARER
Preparer of the Sales Disclosure Form l Title
AMIE 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
Heather A.Thaxton Seller 2-Name as appears on conveyance document *
Address(number and street) IV U V 1 6 202
1427 WEST BOONVILLE-NEW HARMONY ROAD Address(number and street)
City,state,and ZIP Code / h-,eizZQ.li a ,f/f� r, i
Evansville,IN 47725 City,state,and ZIP Code GIBSON COUNTY AUnn-O
Country Country
United States of America United States of America
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.
Signature of Seller(/ /./ y f (.2(, Signature of Seller
Printed Name at Seller ! (� Date a pned mm/ddlyyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Heather A.Thaxton t 1' 'a,40
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 appears on conveyance document
Ashlei Kay Carter
Address(number and street) Address(number and street)
203 E.South Street
City,state,and ZIP Code City,state,and ZIP Code
Fort Branch,IN 47648 C 0
Country
Country p_y
United States of America United States of America
certaip�deductions.Identify all of those that app :
YES NO CONDITION YES O CONDITION
❑ 3. Homestead
0 1.Will this property be the buyer's primary residence?
0 IZI 4. Solar Energy Heating or Cooling System
❑ iZI 2.Does the buyer have a homestead to be vacated for 0 0 5.Wind Power Device
this residence? If yes, provide address: ❑ 0 6. Hydroelectric Power Device
Address(number and street) ❑ I I 7. Geothermal Energy Heating or Cooling Device
City,state,and ZIP Code County A°C ,q - 103 _ooO_ C 23 -0 2_(,.
Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number