Homestead_Furgerson H. PREPARER .
Preparer of the Sales Disclosure Form Title
Payge Marx Escrow Officer
Company
Address(number and street,city,state,country,and ZIP Code)
7412 Eagle Crest Blvd Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Taylor J. Cates llr
Address(number and street) tt
Address(number and streF I L iiir
53 )-(71 C- gdi .E.:
City,statand ZIP Code City,state,and ZIP Code
Uri IC,L.%1,.. ef 1 ii--7 rvi/G110020 MAY 2 6 2023
Country Country
US US
GIBSON COUNTY AyDITOR
Under penalties of perjury,I hereby certify 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 transferred
I property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
S n.tur Ilerjci Signature of Seller
P inted ame ot4Ver (a/4gSDate signed(mm/ddlyyyy) Printed Name of Seller
.45e
Date signed(mm/dd/yyyy)
Taylor J. Cates 05/24/2023
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
Austin Furgerson Carissa Gaston
Address(number and street) Address(number and street)
107 North Elm Avenue 107 North Elm Avenue
City,state,and ZIP Code City,state,and ZIP Code
Evansville, IN 47712 Evansville, IN 47712
Country Country
US US
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
0 n 1.111/11 this property be the buyer's primary E 0 3. Homestead
`-' re "dence? 0 0 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 E 5.Wind Power Device
0 for this residence? If yes, provide address: 0 E 6. Hydroelectric Power Device
Address(number and street) E) 0 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
e2C0 lik—DO-- too _e20(. Cag -60(0
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
transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spouse's
,
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