Homestead_Feagley H. PREPARER
Preparer of the Sales Disclosure Form Title
Christa D.Tracey Escrow Officer
Company
Address(number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as it appears on conveyance document
Bruce A. Gipson Rebecca S. Gipson
Address(number and street) Address(number and street)
_711 E. Evans St. 711 E. Evans St.
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670 Princeton, IN 47670
Country Country
-E-mailUnited States of America United States of America
address
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 requir-__ed to be provided,commits a Level 5 felony.
,-Signature of S- , a Sig ature of Seller y� _
,,,,, , ...,,z,-a.` ....
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller 0 Date signed(mm/dd/yyyy)
Bruce A. Gipson a A. _ 1_ 'r—Rebecca S. Gipson I a -a(- 3 a-`
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL hY
Buyer 1 -Name as it appears on conveyance document Buyer 2-Name as it ap s on pi'veyance document
Timothy Feagley Jessica Fuentes
Address(number and street) Address(number annss re e,`lv�
304 N. Church St.,Apt 4 304 N. Church St.,Ap�4 ,c.1+ �� Y.
City, State and ZIP Code City, State and ZIP Code �� \)°.v,JO0
Fort Branch, IN 47648 Fort Branch, IN 47648 C'
Country Country NG
United States of America United States of America `' SSG
E-mail address
YES NO CONDITION YES NO CONDITION
El ❑ 1. Will this property be the buyer's primary residence? El 0 3. Homestead
❑ El 4. Solar Energy Heating or 40
0 El 2. Does the buyer have a homestead to be vacated for ❑ El 5. Wind Power Device
this residence? If yes, provide address: ❑ El 6. Hydroelectric Power Device
Address(number and street) 0 El 7. Geothermal Energy Heating or Cooling Device
City,State,ZIP code, and county
aLQ - 1 -�- 0—► —(--k(n- ob .c)4 -t0
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete