Homestead_Nossett H. PREPARER
Preparer of the Sales Disclosure Form TitleEscrow Officer
Matthew Jarvis
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)
1 —Name as it appears on conveyance document Seller 2—Name as it appears on ance document
Estate of Barbara G.Atkins �
Address (number and street) Address (number and street)
glee /J �MFcIw ��
City, State and ZIP Code City, State and ZI de �I�
G'/e
, 1) tkvAA-� ct C;4-, I -" >‘..e)
(_ ,i 6 60
tic `���Country
Country OGQ
United States of America �'�_ • ��� Telephone number
E-mail address
best of my knowledge and belief, is4rue,Z'Srrect 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.
Si nature Seller / Signature of Seller
P-i�-u��P 1�� /� �`� �� Printed Name of Seller l Date signed (mm/dd/yyyy)
Printed Name of S er ate signed (mm/dd/yyyy)
William C Atkins, . Personal /9/2023
Representative
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
Cathy Nossett
Brian Nossett
Address (number and street) Address (number and street)
2272 E. Presley Drive
2272 E. Presley Drive
City, State and ZIP Code City, State and ZIP Code
Haubstadt, IN 47639
Haubstadt, IN 47639
Country
Couetry U410
nited States of America
i
Pursuant 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:
O YES NO CONDITION YES NO CONDITION
k. 0 0 1. Will this property be the buyer's primary residence? 0 0 4. Solar Energy Heating or Cooling System
O 0 ❑ 2. Does the buyer have a homestead to be vacated for ❑ 0 5. Wind Power Device
g this residence? If yes, provide address: ❑ 0 6. Hydroelectric Power Device
Address(number and street) ❑ 0 7. Geothermal Energy Heating or Cooling Device
2272 E. Presley Drive
' t City, State.ZIP code, and county I -(Q�0!'`�� a (L{ - �
Haubstadt, IN 47639 Gibson OO
t 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 �llueeo'of
transferred real property,or omits or falsifies any information