Homestead_Gould H, PREPARER
Pepare,n,the Sales Disclosure Form Title
PaygmPNarx Escrow Officer
Company
Adu,nux(number and street,city,state,counhx and ZIP code)
7412 Eagle Crest Blvd Evansville, |N47715
U. SELLER(S)/K@FANTOR(S)
Seller 1-Name aui/appears nn conveyance document sa||erz-mamoaoappeamnnonnvoyanoouuoumont
Ronald Smith Nancy Smith
A« , L� �\ [ Adu—`-�'~t-� a e V
'
r7~/-�
un«zponu* City '�/l
_
ode
cnua � 7 �� � � qZr1P` u )
Country np ''
J
UQ US
Sig :' � not fa x
�aat,�uS
`
pnn�oName maenor Date signed(nmxd»lyno) Printed Name mSeller Date signed(mmmo4ryy
Ronald Smith 07/14/2023 Nancy Smith 07/14/2023
J. BWYER(S)/GRANTEE(G)-APPLICATIONIV ALL THAT APPLY
Buyer 1-Name ooitappu000n conveyance document auyerx-womoa oPon � �
'uoxumpnt
�� �'
Dustin Edward Gould, Jr.
Address(number and street) Address(number and street)
41 Eleventh Street Vol - '4&
City,state,and ZIP Code City,state,and 24ode
Tell City, |N47588 ,
Country Country 'us US -
YES NO oOmomom
1 V�U(hiopmpo�y primary [� [] 3. Homestead
[� [] ' ~~ ~~
residence? [] E3 4.Solar Energy Heating or Cooling System
3 Does the buyer have a honn \ed LJ 5l 5.VWnd Power Device
`�^r�or this residence? |fy��,providea"'� ' 0b0 a. Hydroelectric Power Device
' ` ' ~�� �_ �n�°�� �
Address(number and ot,euV ~
O E 7 Geothermal E Heating Cooling Device
Under penalties of perliury,I hereby his Sales um osure,to the best of my knowledge and belief,is true,correct and completie
u '