Homestead_Glass (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Shelby Head Closing Agent
Company
Address(number and street,city,state,country, and ZIP Code)
4905 Theater Drive, Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on y document \
Joe Kinsall
Add ress number and eet)(� Alit Address(number and street) n
.t(v1 lltl 1/ den ,,
411) '
City,c tale,and ZI'Code O City,State,and ZIP Code \ Q. /
td il.,)07
vi ma
Country Country %,,,0
USA 'ye
E-mail Address
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.
(Si ature of S Iler Signature of Seller
nted Name o Seller Date Signed (mm/ddlyyyy) Printed Name of Seller Date Signed(mmlddlyyyy)
Joe Kinsall September 1, 2023 September 1, 2023
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
Paul Glass Stacy Glass
Address(number and street) Address(number and street)
1503 South Main Street 1503 South Main Street
City,State,and ZIP Code City,State,and ZIP Code
Princeton, IN 47670 /�_ t,(1 Princeton, IN 4760 ,
YES NO CONDITION Y�S NO CONDITION
Nikl 1.Will this property be the buyer's primary E 3. Homestead
❑ residence? ❑ 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated ❑ 5.Wind Power Device
❑ for this residence? If yes, provide address: ❑ 6. Hydroelectric Power Device
Address(number and street) 0 7. Geothermal Energy Heating or Cooling Device
City,State,ZIP code,and County -O,\Z (<3 - �O2- 600• rQ^ .
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