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Homestead_Sollman (17) H. PREPARER
Preparer of the Sales Disclosure Form Title
Abbigail Moers Escrow Officer
Company
Address(number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as it appears on conveyance document
Harold R. Bowers Jimmie R. Bowers
Address(number and street) Address(number and street)
4922 E. 1150 S. 4922 E. 1150 S.
City, State and ZIP Code City, State and ZIP Code
Haubstadt, IN 47639 Haubstadt, IN 47639
Country Country
United States of America United States of America
E-mail address
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.
-Sig!nature of Selle „J atu Seller —
Printed Name of Seller Date signed(mm/dd/yyyy) Printed me of Seller Date signed(mm/dd/yyyy)
Harold R. Bowers 4/26/2023 Jimmie R. Bowers 4/26/2023
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
Nikki A. Sollman
Address(number and street) Address(number and street)
9899 Warrick Trail
City,State and ZIP Code City, State and ZIP Code
Newburgh, IN 47630 \/�
Country Country OR
United States of America ,f ?8 A
E-mail address
certain deductions.Idei yj (.' e that appl(:
YES NO CONDITION YE NO CONDITION AVO/T `X)
El1. Will this property be the buyer's primary residence? 0 3. Homestead OR
0 El 4. Solar Energy Heating or Cooling System
0 t 2. Does the buyer have a homestead to be vacated for this ❑ El 5. Wind Power Device
residence? If yes,provide address:
0 El 6. Hydroelectric Power Device
Address(number and street) ❑ El 7. Geothermal Energy Heating or Cooling Device
City,State,ZIP code,and county ' /� �/
` Wl •-
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
1.1
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