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Homestead_Flake H. PREPARER Preparer of the Sales Disclosure Form Title - Scott Morris Escrow Agent Company Address(number and street,city,state,country,and ZIP Code) 4600 Washington Ave, Suite 102, Evansville, IN 47714 I. SELLERS)/GRANTOR(S) Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyance document Brett D Riley Address(number an street), Address(number and street) 1A30 4/ Valfu / �Ay City,State,and ZIP Code City,State,and ZIP Code Q Ililouy4 ( Ir oeta3 14 Country Country 1 -4674. 4p, Email Address best of my knowlec 'e,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 1 4fi a falsifies the value of transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. (lN ' fi�. Siena ell Signature of Seller �',q� - O/7.O Printed Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy) Brett D Riley (VI f 2 T J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY — J Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document Abigail Flake Lane Afan Winget A4iiess(11PrIter and stree_ti Ad ress(number and street)' �1 . f o) , Poitc Drr, City,State,and ZIP Code —, Ci State,and ZIP Code 0 rCk\(1a� C t\ 0 laic 1ar1c. (-Al-Y j r A/ H 7660 Country / Cot rksy) 0 EmaAddress Plk �� YES NO CONDITION YES NO CONDITION X 0 1.Will this property be the buyer's primary Q 0 3. Homestead ,,. o residence? 0 © 4.Solar Energy Heating or .o of nay 3. 2.4 F 2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device O ` for this residence? If yes,provide address: 0 © 6.Hydroelectric Power Device Address(number and street) 0 Q 7.rGeothermal Energy Heating or Cooling Device City,State,and ZIP Code County 6, ` 1 _ I �(.4,0 l _ 0 o( /1((. _0 O 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