Homestead_Gooch (4) 3 H. PREPARER
Preparer of the Sales Disclosure Form . Title
Milton Norman Settlement Agent
Company Email address
Address(number end street,city,state,country,and ZIP Code)
25 NW Riverside Drive,Suite 310,Evansville,IN 47708
I.SELLER(SYGRANTOR{S)
Seller 1-Name as it appears on conveyance document Seller-2 4 Name as appears on conveyance document
Chelsey M.Rigg,nka Chelsey M.Hest
Address(number d street) Address(number and street) 4>
ity,state.and ZtP Code City.state.and ZIP Code \.J
' '11(''41 -C-.)
Country Contry G I
US _ c%s 1
best of my knowledge and belief, - • ; - 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! '- . -value of transferred
real property,or one orb any information required tonrr be provided.codts a Level 5 felony. rO
S' er4171,4 Signature of Seller ?
Printed Name Date signed(inm✓dp'yyy) Prided Name of Seller Date signed(rnrniddtyyyy)
Chelsey M.Rigg,nka Chelsey M.Hest 08/10/2023 08/10/2023
J. BUYER(S)1GRANTEE(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
Trenton Lamont Gooch Samantha-Rice
Address(number and street) Address(number env euuur
-7 r_Cj ...4 ‘s,\-- 728 S.Main St
City,state.and ZP Code City,state,and ZIP Code
Princeton,IN 47670 Princeton,IN 47670
Country Country
US US
E-maa address
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary (Xi m
D 3_Hoestead
(XIresidence? 0 12 4.Solar Energy Heating or Cooling System
0Qi 2.Does the buyer have a homestead to be vacated 0 ( 5-Wind Power Device
For this residence?If yes,provide address: O Q 6.Hydroelectric Power Device
Address(number and street) D D 7.Geothermal Energy Heating or Cooling Device
City,state.ZIP code,and county Z.6_1Z_ O 1_>d4-03 3,Q(13--O 22
Under penalties of perjury,I hereby certify that this Sales Disclosure,to Ore best of wry knowledge and belief,is true,correct and complete
- -
Page 3 of 5 COP\