Homestead_Bates (9) H. PREPARER '
Preparer of the Sales Disclosure Form Title
Diana Rich Title Administrator
Company
Address(number and street,city,state,country,and ZIP Code)
20 NW First Street,Suite 100,Evansville,IN 47708
I. SELLER(S)/GRANTOR(S)
Seller 1—Name as It appears on conveyance document Seller 2—Name as appears onFiarcrint
Abner Homes and Contracting,LLC
Address(number and street) Address(number and street) ID i
8572 West SR 65
City,state,and ZIP Code City,state,and ZIP Code BAN 2 4 2023 ('
Hazelton, IN 47640
Country Country
USA
E-mail address
Under penalties of perjury,I hereby certify 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 transferred
real property,or omits or falsifies any Information required to be provided,commits a Level 5 felony.
nature of Seller Signature of Seller
-.1Printe ame o Seiler Date sign d(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Derek S.Abner I/)i .2
J. BUYER(S)/GRANTEE(S)—APPLICATIO 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
Michael G.Bates Rose K. Bates
Address(number and street) Address(number and street)
tO $ 0 5c-- long a W, S\--
City,state,and ZIP Code City,state,and ZIP Code
S't-iilye -n i l-.1 L-/"7( 76 Qc, AceN•n , I 147Y TO
Country Country
USA
E-mail address
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer s primary
residence? CI 0 3. Homestead
❑ ❑ 0 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 El 5.Wind Power Device
❑ for this residence? If yes,provide address: 0 El 6.Hydroelectric Power Device
Address(number and street) 0 El 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county (_ ^v r) ^ r-,-/_ n? _t)n ) _Ol n 7 - fl,'
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best17of 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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