Homestead_Collman H. PREPARER
Preparer of the Sales Disclosure Form Title
Gabrielle Brooks Title Examiner
Company
Address(number and street,city,state,country,and ZIP Code)
25 NW Riverside Drive,Suite 310,Evansville IN 47708
I.SELLER(S)I'GRANTOR(S) }s
Seller 1—Name as It appears on conveyance document Seller 2—Name as appears on jva je do m
Dekajuan A.Halbig Marisa Halbig ��������� D
A Ire numb r end street) / Address(number d street) —
e. C'.<<r i-�GI P.r 5 Plij EC 3 0 9
City, te,apd ZIP Code City,state,aan P
III I l'1.r.Z�v1 'l� �-1 7(0 �7 U �c,. ��yy,,,,��
Country ( USA try C(/M'"A(/' n r)
USA
E-mail address
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,comml evel 5 felony.—`
xfignattuur of
Seller _ S" na ler
/`Prints Nartie of Seller Date sipped( m/dd/yyyy Printed ame of Seller Date sipped( m/dd/yyyy)
Dekajuan A.Halbig IZt (ZZ Marisa Halbig (21'zD(ZZ
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
Hannah Coltman Mark Boyd
Address(number and street), Address(number and street)
) 1�,e S- l'Vla c n_ 1
CI fate,and ZIP Code O City,state,and e
Fri A'-t- 0". / `r lJ Country
Country
certain deductions.Identify all of those that app y:
YES NO CONDITION YES NO CONDITION
0 0 1.Will this property be the buyer's primary
0 3.Homestead
residence? 0 4.Solar Energy Heating or Cooling System
12071.Does the buyer have a homestead to be vacated
0 0 5.Wind Power Device
0 for this residence? If yes,provide address: 0 0 6.Hydroelectric Power Device
Address(number and street) o I] 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county - /__ ra- (- 7 —3D!-..' _ DDO . -7Z(p -(5,, ,m�
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,Is true,correct and compete
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.(Note:Both spouse's
! /