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Homestead_Henson
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 1 I. SELLER(S)/GRANTOR(S) i Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document Rod Payne Address(number and street)._ Address(number and street) (:',2 a.0 57. e)es E, tp Cil ,Stalc and ZIP Code City,State,and ZIP Code Country Country `/(i/4/ mil) Email Add s' of my knowledge arid ,i e,correct,an complete as required by law,and Is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and Inten y s the v u o ansferred real property, omits or falsifies any information required to be provided,commits a Level 5 felony. '10 Sigrr to e.o ` et r Signature of Seller O/i- .„,:;-'(.- Printed Name of Seller 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 Brittney Nicole Henson A dres (number nd streetj 9 Address(number and street) State, ¢ZIP Code .e 4.� ,7 D City,State,and ZIP Code nACA. ountry Country Email A ss rphQnefNumbei Email Address Telephone Number 1 1�� ZI�f_1t� � 3'7� ( ) 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 YE NO CONDITION D 1.Will this property be the buyer's primary O 3.Homestead residence? D © 4.Solar Energy Heating or Cooling System X 2.Does the buyer have a homestead to be vacated D O 5.Wind Power Device D: for this residence? If yes,provide address: D D 6.Hydroelectric Power Device O` ep nu...)' /Vs e;�t) __ 1 D p 7.Geothermal Energy Heating or Cooling Device pa.y,State,aJannd ZIP odde(J by County q/ �1�� O b ocAsrvil Le, I N to tt �(Ip 1- M2-000 .43E-02-8, Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,Is true,correct,and complete , a