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Homestead_Hicks (4)
H. PREPARER i Preparer of the Sales Disclosure Form Title Stacy L. Brown Escrow Agent Company Address(number and street,city,state,country,and ZIP Code) 4600 Washington Ave, Suite 102, Evansville, IN 47714 I. SELLER(S)/GRANTOR(S) Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears o onveyance document Phyllis Lechner Address(number and street) Address(number and street I 1109 Ci0 Hront,iof br City, State, and ZIP Code City,State,and ZIP Code Ape f ri nc�n I J;J Li�1y r7© •Joy Country Country ��2 2Q23 Email Address knowledge and bel ef�a1 ct,and complete as required by law,and is prepared In accordance with IC 6-1.1-5.5.A person who knowingly and intentionally fa igthe value of transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. Signature of Seller Signature of Seller mm/dd(ned Printed N e of Seller ' Date Signed(mrrr/ddlyyyy) Printed Name of Seller . Date Si P by 11 i s �ci n er ig. �_ a g ( may) 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 Anthony Hicks Address(number and street) Address(number and street) Ci '�� o plat H1 Hs Or. City,State,and ZIP Code City,State,and ZIP Code elri il(L' t.5ki tot 1(0r70 Country Country for certain deductions.Identify all of those that apply: `^ YES NO CONDITION Y,E_S/ NO CONDITION 1.Will this property be the buyer's primary 0 3. Homestead residence? 0 © 4. Solar Energy Heating or Cooling System l 2. Does the buyer have a homestead to be vacated O O 5. Wind Power Device 0, for this residence? If yes, provide address: O © 6. Hydroelectric Power Device 8Address(number and street) 0 © 7. Geothermal Energy Heating or Cooling Device O City,Slate,and ZIP Code County 0r� 6r ulco4$ C1 bslr,l %-11_-13-�z-0ol- 340-02,- - uv1G� i t� 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 requ law,and is prapar in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of ,,. trans rred r al property,oX om r falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spouse's -- I. ' ?M1'' t