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Homestead_Falls
H. PREPARER - Preparer of the Sales Disclosure Form Title AMIE MASLANKA Escrow Officer Company Address(number and street,city,slate,country,and ZIP Code) 5231 Oak Grove Road,Suite A,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 Jacob Taylor _ Haley S.Taylor _ Address(number and street) 252. .U) Z 4.. 2.52. ICU 2"'1 Si Address(number and street) City,state,and ZIP Code rl.+w1Ne X-I1/41 4-1 (t,(9 l:j nnu Ale =.I\1 4,to l 9 City,s te,and ZIP Code Country Country United States of America United States of America 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. Signature of Sa yr--- Signature of Seller fry // ! /1 inted Name of Seller Date signed( m/dd/yyyy) Printed Name of Seller Date sig d(mm/dd/yyyy) Jacob Taylor 01/Ol.12o23 Haley S.Taylor 07 /D/o f2./23 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 appears on conveyance document Katie Falls Address(number and street) I Address(number and street) -Ast 415 South Main Street City,state,and ZIP Code City,state,and ZIP Code f Owensville,IN 47665 ,4 : 11 i 1 Country I Country United States of America United States o '-rica �> '1 ?©? for certain deductions.I f those that apply: YES CONDITION YES NO CONDITION �O�jo 0 1.Will this property be the buyers primary residence? El3. Homestead A I 0 RI 4.Solar Energy Heating or Cooling System ❑ 0 2.Does the buyer have a homestead to be vacated for ❑ 0 5.Wind Power Device this residence? If yes, provide address: 0 © 6.Hydroelectric Power Device Address(number and street) ❑ Q 7.Geothermal Energy Heating or Cooling Device City,state,and ZIP Code County U-9--1Z-Z0 y-000.2-3 —o 2-2_ Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, Is true,correct and complete