Homestead_Sherman (4) H. PREPARER
Preparer of the Sales Disclosure Form Title
Christa D.Tracey Escrow Officer
Company
Address(number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as it appears on conveyance document
Estate of Gilbert K. Kirby,deceased
Address(number and street) Address(number and street)
801 S Hall St.
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670
Country Country
United States of America
Email Address
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.
SigLiatu0 of Se r � Signature of Seller
P ,¢
Printed N me of Seller c/ Date signed(mm/dd/yyyy) Printed Name of Seller Date signed (mm/dd/yyyy)
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT •
Buyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appear on e irR- document
'Hunter Sherman [Y1
Address(number and street) Address(number an e ,�
1343S100W .%1
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670 ` ,j(+ vR
co 0
Country
United tates of America Country 4" O N,�.( P
Email Address
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 Y NO CONDITION
❑ 1 Will this property be the buyer's primary residence? ❑ 3. Homestead
0 4. Solar Energy Heating or Cooling System
0 2. Does the buyer have a homestead to be vacated for ❑ �5. Wind Power Device
this residence? If yes, provide address:
0 IZ-/ 6. Hydroelectric Power Device
Address(number and street) 0 D 7. Geothermal Energy Heating or Cooling Device
City, State, ZIP code, and county
��- la-is• ia 031 • 4c( - �a�
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Other Number
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