Homestead_Fenwisk H. PREPARER
Preparer of the Sales Disclosure Form - y W Title
Amy B. Pollard Settlement Agent
Company
Address(number and street,city,state,country,and ZIP Code)
7820 Eagle Crest Blvd, Suite 201, Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
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Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Richard Georges, also known as Richard J. Georges, Jr. Josh Meeks
Address(number nd street) Address(number and street)
3 I(oZ S, 6 SO a15-- E- 3dcS
City,State,and ZIP Code City,State,and ZIP ode
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Country Country
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real property,or omits or falsifies an
g information required to be provided,commits a Level 5 felony.
gature of S e r� , Si. - . • of.eller
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' fir!/�/% 6,--Printed Name o Seller Date Signed(mm/ddlyyyy) Pry•=d Name of Seller Date gned •.
Richard Georges.also known as Ricilard J.Generics Jr. r;/ arq Josh Meeks y /r
l J. BUYERS)/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
Adam J. Fenwick
Address(num er and street) p\stAddress(number and street)
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City,State,and ZIP Code _ City,State,and ZIP Code
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apply for certain deduct' all of those that apply 1
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.YES NO CONDITION YES NO CONDITION �-
1.Will this property be the buyer's primary 3.Homestead
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residence? 0 C) 4.Solar Energy Heating of›.
11,9oling Syste• �11
• 2. Does the buyer have a homestead to be vacated 0 0 5.Wind Power Device
' for this residence?If yes,provide address: 0 0 6. Hydroelectric Power Device
Address(number and street) 0 0 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County 0( 1-- C 7 "4 0
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Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct,and complete
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