Homestead_Williams (2) H. PREPARER
Prepare(of the Sales Disclosure Form Title
Milton Norman._ r _-,__..,...........,,._.. ..,_.... _,...__.____._.. _ ` Settlement Agent
Company E-mail address
Address(number end street.city.state.country,and ZIP Code)
25 NW Riverside Drive,Suite 310, Evansville,IN 47708
I SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conve , .c 1p
Katie M.McEllhiney
Address(num r and street) (, Address(number and street) AUG l
_ 1127. � 11� Q i�i� 1 CI _._ ?��3
City,state,and ZIP Code City,state,and ZIP
Country Country .4j
US R
- mail address Telephone number
Under penaft f'.erjury,I hereby certify 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 transferred
real property,or omits or falsifies any Information required to be provided,commits a Level 5 felony.
Signa of Seller _ . Signature of Seller
t`l/rirlC..
Printed Name of Seller D t sign (mmfddryyyy) Printed Name of Seiler Date signed(mmiddtyyyy)
Katie M.McEllhiney_ y),9'5
J. BUYER(SWGRANTEE(S)—APPLICA ON FOR PROPERTY TAX DEDUCTIONS-IDENTIFY AL_L THAT_APPLY Y�
Buyer 1 Name as it appears on conveyance document ; Buyer 2-Name as it appears on conveyance document
Latasha R.Williams Jacob A.Williams
Address(number and street) , Address(number and street)
7920 Rels Road ; 7920 Reis Road
City,state.and ZIP Code ; City,state,and ZIP Code
Evansville,IN 47720 Evansville, IN 47720
Country ' Country
US
_ffor certain deductions.IdentN r all of those that ap IpI •�
YES NO CONDITION
YES NO CONDITION
® O 1.Will this property be the buyer's primary ( 0 3. Homestead
residence? 0 4. Solar Energy Heating or Cooling System
O IA 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) ....,1
0 Cg 7. Geothermal Energy Heating or Cooling Device
City,slate.ZIP code,and county
i L O i 3- -I(i - . 0 - j
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and bellef,Is true,correct and complete
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