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Homestead_Potts
H. PREPARER Preparer of the Sales Disclosure Form Title Jamie E. Smith Escrow Officer Company Address(number and street,city,state,country,and ZIP Code) 101 Plaza East Boulevard, Suite 102, Evansville, IN 47715 I. SELLERS)/GRANTOR(S) Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance doc ment MICHAEL POTTS Address(number and street) Address(number and street) ,-> ls. 's 1105 W County Road 525 South t`✓�l City,State,and ZIP Code City,State,and ZIP Code 9p� Oakland City, IN 47660-8946 ''):4?) Country Country I E-mail Address 41/ •,T Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,Is true�,7'4Wi nd complete as required by law,and is prepared In accordance with IC 6-1.1-5.5.A person who knowingly and intentionally faisifie lue of transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. 0,9 5igna u e Sell r Signature of Seller e/ ,,, .g.„ 6,02/4--- a? -- 23 12423 ,4 Pn ted Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy) MICHAEL POTTS March 23, 2023 March 23, 2023 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 MINDY M. POTTS Address(number and street) Address(number and street) 12935 E 75 South City,State,and ZIP Code City,State,and ZIP Code Oakland City, IN 47660-8130 Country Country apply for certain deductions.Identify all of th e t t:-ply: YES NO CONDITION YES O CONDITION � �❑ I.Will this property be the buyer's primary ❑ 3.Homestead uY: •- �: residence? ❑ ©"4.Solar Energy Heating or Cooling ,'s'' >' Does the buyer have a homestead to be vacated El5.Wind Power Device ;vice ❑ © for this residence? If yes,provide address: ❑ ©�,6.Hydroelectric Power Device Address(number and street) ❑ © 7.Geothermal Energy Heating or Cooling City,State,ZIP code,and County 6r I(-1- r2 3�-©o©‘ �73 - (90 Gj • Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of f mlyTknowledge 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.(Note:Both spouse's 3