Homestead_Keeton ` H. PREPARER - - - — _
Preparer of the Sales Disclosure Form Title
Amy B.Pollard Settlement Agent
Company
Address(number and street,city,state,country,and ZIP Code)
7820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715
I. SELLERS)/GRANTOR(S)
1 Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Logan Starnes
Address(number and street) Address(number and street) FILED
1704 Kennedy Drive
City,State,and ZIP Code City,State,and ZIP Code
Princeton,IN 47670 SEP 2 I 21'ij
Country Country
US
GiBSON COUt y q pi p
Under penalties of perjury,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.
Signature of S Ilgr 1 Signature of Seller
C-C. 0.(+L I L '\
Printed Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/ddlyyyy)
Logan Starnes 09/14/2023 09/14/2023
J. BUYERS)/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
Perry Keeton
Address(number and street) Address(number and street)
3556 Laurel Ridge NW
City,State,and ZIP Code City,State,and ZIP Code
Roanoke,VA 24017
Country Country
US
1 ( )
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
® 1.Will this property be the buyer's primary (2) 0 3. Homestead
residence? 0 3 4. Solar Energy Heating or Cooling System
IX) 2. Does the buyer have a homestead to be vacated 0 NI5.Wind Power Device
for this residence? If yes, provide address: 0 ® 6. Hydroelectric Power Device
Address(number and street) 0 ® 7. Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County ok , `1 - O%,/Q,. -002 03 Z _ 023
_
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