Homestead_Mason (9) 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 conveyance document
Scott D. Patterson Holly A. Patterson
dress( land street) Address(number)and street) , .\
CP
City,state,and ZIP Code City,state,and ZIP Code
Co my it Country 5
E-mail address
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.
6:11nature of Seller A Si9n9ture of Seller
Printed Name of Seller Date signed(mm/dd/yyyy) Print Name of Seiler Date signed(mm/dd/yyyy)
Scott D. Patterson /v- 3- -2,4 Holly A. Patterson ,/--„j 14t.),L
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 arruprt
Glenna Irene Mason
mp(� (nVrrt�ef and s reet . Address(number and street) S
,Elate.and Z Code City,state,and ZIP Code UEU 09 2022 ft
( n -(in . - cam. 1-I--cUi0 � /
Coun3`ry_AS Country c'l &. p 2&
E-mail addr E-mail address GID^O 9ene nurfSbeOR
7 epho
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P scant 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 YES, NO CONDITION
1.Will this property be the buyer's primary /y�at'''/ 0 3.Homestead
O residence? 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
D for this residence?If yes,provide address: 0 O 6.Hydroelectric Power Device
Address(number and street) 0 O 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county 26 - 2_\ 1—
rJ Oo_o p(-( O /ct __o 2
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
s