Homestead_Ungetheim H. PREPARER
Preparer of the Sales Disclosure Form Title
Amy B.pollard .,...._ Settlement Agent
_ —_______________
Company
I.SELLER(S)/GRANTOR(S)
,
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveya
Donald Lynn Curl Ellen Curl
4...)Address(number and street) Address(number and street)
105 ThompsoIn Court 414R 105 Thompson Court
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City,state.and ZIP Code City.state,and ZIP Code >34 202
1b
Owensville,IN 47665 Owensville,IN 47665 •
Country Country GIS.,904ie-Te0, 4
US US I IV C te- ' f-/
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 is Level 5 felony.
Signature of Seller Signature of Seller
ft-• l' I\ke\rt Se A-VtociAeA
Printed Name of Seller Date signed(mmidd(yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Donald Lynn Curl 03/08/2023
Ellen Curl , 03/08/2023
1 J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
I
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
1
I Jacob Ungetheim Lori Ungethiem
IAddress(number and street) Address(number and street)
13404 Tamarack PI 13404 Tamarack PI
,
City.state.and ZIP Code City.state,and ZIP Code
Choctaw,OK 73020 Choctaw,OK 73020
I-Country Country
US US
.. :
YES NO CONDITION YES NO CONDITION
0 1.Will!his property be the buyer's primary v.4 0 3. Homestead
residence? 0 r. 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated
Le6,L 0 GI 5.Wind Power Device
for this residence?If yes,provide address: 0 II4 6.Hydroelectric Power Device
Address(number and street) 0 Cj§ 7.Geothermal Energy Heating or Cooling Device
City.state.ZIP code,and county
2-C-V1-0 —300- 00 0- C 5--02 ( .
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 the value of
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