Homestead_Buchanan (2) 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. SELLERS)/GRANTOR(S) -
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
The Estate of Barbara Jean Singleton -
Address(number and street) ,-- Address(number and street)
7 t)
1 ,3 avc Z3 h _ -
City,sta ,and ZIP Cock City,state,and ZIP Code
4..e,L4'1.--r ((le _I-M. y--7 v 5
Country Country
E-mar dtlress
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.
Sig of
QL)oy Signature of Seller
��a4u ���'R R m t'
Date signed(mm/dd/ ) Printed Name of Seller Date signed(mm/dd/yyyy)
Printed Name of Seller 9 m'y
Nicholas Singleton,Personal Representative /Z-2_y+- Z2--
J. BUYERS)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DED TIFY ALL THAT APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Nam s it pears ontrerRAnce document
Mackenzie Buchanan cti `
Address(number and street) Address(number and st t' p i 1 ,
a'Y
o. ��
City,state,and ZIP Code City,state,and ZIP Code N
_t N j-( 1 Co'L 0 ''�y r� vi a c
�c-inc_e.-�-oro J
Country Country G\�'
E-mail address
CONDITION
❑ 1.Will this property be the buyer's primary
0 3.Homestead
residence? 0 IE 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated
0 O 5.Wind Power Device
❑
for this residence? If yes, provide address: 0 D 6.Hydroelectric Power Device
Address(number and street) 0 p 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county 7-1 O_` _1Z)-1 - l 0-a- nc o ,-7-,u,3-paPt.
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
5 coPY
` V `
4