Homestead_Miskell (16) H. PREPARER �- V _ i
Preparer of the Sales Disclosure Form Title
Courtney Pruett Title Clerk
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
Minnie R. Krieg Deatra Laswell
Address(number and sire Address(number ap,d street) _
Q 47g3 S. � (cka/)C Fd
State,and ZIP de City,State,and ZIP Code
co ntry i Country
Email. dress
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.
Signs a nl Seller 4Signature of Seller
0041--4-1 e_/---,),-07,5 A,\..,
Printed Name of Seller / Date Signed(mm/dd/yyyy) Printed Name of Seller - Date Signed(mm/dd/yyyy)
Minnie R. Krieg / Deatra Laswell
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
Steve Miskell Star Miskell
AddAd rgss mber�nd stye ��� t �j Address.(nu ber and street a
aa,
Cit t' e,and ZIP,C de. State,and ZIP Code
i/ IIC /-4)7/ /� ` 76?0 �►n c-e-}on .-4-=N, `17 ,?6
Country Country
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Email A ess
YES NO CONDITION E NO CONDITION
O 1.Will this property be the buyer's primary O 3. Homestead
residence? O B 4.Solar Energy Heatin•0 y ooling System
2.Does t ulb v- . omestead to be vacated 0 B 5.Wind Power Device :' �
O for this f es o.'.e address: '� 1x��
0 B 6.Hydroelectric Power Devi ` •
Address(numb n tre �)--‘ 0 B 7.Geothermal Energy Heating or Cooling nevice
City,State,a P ode yo�� County
�ti� A6-11 —Q 1-2_03-000 In-02 ,
Under penalties of perlllr,I hereby ce , s Sales Disclosure,to the best of my knowledge and belief,is true,correct,and complete
as required by law,and`7Is prepared nce with IC 6-1.1-5.5.A person who knowingly and Intentionally falsifies the value of
transferred real property,or omi Pies any Information required to be provided,commits a Level 5 felony.(Note:Both spouse's