Homestead_Kolb (6) H. PREPARER
Preparer of the Sales Disclosure Form Title
Abbey Moore Closing Agent
Company
Address(number and street,city,state,country, and ZIP Code)
4905 Theater Drive, Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Jack E. Hale FILED
"Aft-is anQrftreet) Address(number and street) l/
-)
1lllglllity:'shale,and ZIP
ZZZIPP Code City,state,and ZIP Code DEC 2 0 2022 (:.
cl
Country Country e y�
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.
..)..s.: Signa ure Seller By C`..-7, �/ Signature of Seller
rated Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Jack E. Hale bt,1 Chris tl I-Ne_.December 13, 2022 December 13, 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
Jason Kolb
Address(number and street) Address(number and street)
602 South Seminary Street
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670
Country Country
apply for certain deductions.Identify all of those that apply:
YES NO CONDITION, YES NO CONDITION
rr----{{ 1.Will this property be the buyer's primary 0 0 3.Homestead
00 residence? ❑ Q 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 El5.Wind Power Device
El
this residence? If yes,provide address: 0 0 6. Hydroelectric Power Device
Address(number and street) 0 Q 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county kv-`.__ 01 6,0 1 -d°1 13 2- 0 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
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