Homestead_Phillips (13) P eparer oft Sales Disclosure Form Title
Stacey Salzman Settlement Agent
Company
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Address(number and street,city,state,country,and ZIP Code)
2301 N.Burkhardt Road,Evansville,IN 47715
:ti;;SELLER(S)JGRANTOR s:-i:':`.:: : , : •.•: :'::;:.•• :.:.__ , •.- • :. ::.: •.
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Seller 1.-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Steve Fulcher Karen A.Fulcher
Address(number and street) Address(number and street)
POBox5 POBox5
City,State,and ZIP Code City,State,and ZIP Code
Oakland City,IN 47660 Oakland City,IN 47660
Country Country '
US
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'sea:pro a •,qr omits at';falsifies an3t information.required to.be.provlded,coinm7ts:a.Leve1:5:felonry , .,.
Signatu f Seller S ure Seller
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Ffinte ame Se er Date Signed(mmlddlyyyy) Printed Nam of Seller Date Signed(mm/ddlyyyy)
Steve Fulcher 05/12/2023 Karen A.Fulcher 1 511 2/202 3
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E.:P..BUlYER(S)/GRANTEE(S) PLICATION:FOR.PROPERTY.717.#DEDUCTIONS IDENTIFY 4tl,,T t :: ••R f Y'-: :. ; ...::::
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance•oc r•',•
x;:
Michael Phillips " ,i);
Ad�sts(nu tuber and 2 i 1,)r),v, .cisct._. Address(number and street) ✓v�b
eis
City,- to and Zli'Code Sty,State,and ZIP Code 202
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Country ` Country 4:,‘ ON CUS O0Q��
Email Address -
certain deductions,Identify'ati:of those that apply::.. ....: i
YES NO CONDITION YES NO CONDITION
o 1.Will this property be the buyer's primary 3.Homestead
residence? 0 IA 4.Solar Energy Heating or Cooling System
0 in -2.Does the buyer have a homestead to be vacated 0 ® 5.Wind Power Device
for this residence?If yes,provide address: 0 ® 6.Hydroelectric Power Device
Address(number and street) 0 (Xi 7.Geothermal Energy Heating or Cooling Device
City.State,and ZIP Code County .
IL(..-t3 '40 t--.00t 8% _o o 4-
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