Homestead_Sumner (2) H. PREPARER - — --
Preparer of the Sales Disclosure Form Title
Kris Coon Closing Agent
Company
Address(number and street,city,state,country,and ZIP Code)
_ — -- —
4600 Washington Ave., Suite 102, Evansville, IN 47714
-
I. SELLER(&)/GRANTOR(&)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on anco document
Teresa Stelling
— —— -- -Address(number and street) Address(number andd street)
eet)
106 Lily Ct tj
City,state,and ZIP Code City,state,and ZIP Code
Allen, TX 75002 gU(12
Country Country G/e � L
k , ? __
( NT).•' a
Under penalties of perjury,i hereby certify this Sales Disclosure,to the best of my knowledge and belief,Is true,1. opt and complete as
required by law,and Is prepared In accordance with IC 6-1.1-5.5.A person who knowingly and Intentionally falsifies ttie 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
-a. `lVn
Arin d Name of Seile Date sign (mm/cIwyyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
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
Rhonda Sumner Darrell Sumner
Address(number and street) Address(number and street)
l I ` .,PVCirk __.Seto r moat Si •
City,state,and ZIP Code City,state,and ZIP Code
__.__ 1{1^nC2!11^n_ 147l290
Country Country
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to appl for certain deductions.Identify all of those that apply_
_YES NO CONDITION Y-ES/ NO CONDITION
7 O 1.Will this property be the buyer's primary bd 0 3.Homestead
residence? 0 CV 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 d 5.Wind Power Device
for this residence? If yes,provide address: 0 W. .Hydroelectric Power Device
Address(number and street) 0 LYY 7.Geothermal Energy Heating or Cooling Device
— - __...__.....-----..—
City,state,ZIP code,and county
-- L\el -rTh ,--), r _ ..E)
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 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
_ ._
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