Homestead_Hankins H. PREPARER
Preparer of the Sales Disclosure Form i Title
Milton Norman Settlement Agent
Company E-mail address
Address(number and street,city.state.country, and ZIP Code)
25 NW Riverside Drive,Suite 310,Evansville, IN 47708
I. SELLER(S)JGRANTOR(S)
Seller 1-Name as it appears on conveyance document ( Seller 2-Name as appears on co merit
Thomas A.Grimm,Jr. Shelly L.Grimm
Address(number and street) Address(number and street) ,
10824 W 925 S 10824 W 925 S _ ��`-
City,state.and ZIP Code City.state.and ZIP e �I<2
Poseyville,IN 47633 Poseyville, IN 476 6? 99
Country Country /BSCti O`9 \
US US C CD \ v
E-mail address Telephone number E-mail address '
{ } tiTy Telephone num
-ge
",_ ( )
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is and complete as
required by law,and is prepared in accordance with IC 64.1-5.5.A person who knowingly and Intentionally fatsvalue of transferred
real property,or omits or falsifies any Information required to tie provided,commits a Level 5 felony.
Signature of Seller Signature of Seller
Printed Name of Seller Date signed(mm/ddryyyy) Printed Name of Seller Date signed(mm/ddlyyyy)
Thomas A.Grimm,Jr. Shelly L.Grimm
J. BUYER(S)JGRANTEE(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
Gregory Scott Hankins Elizabeth Hope Hankins
Address(number and street) Address(number and street)
City.sate.and ZIP Code Cied r}a ar+d ZIP Code
Country Country
US US
E-mail address
to apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
al D 1.Will this property be the buyer's primary ® 0 3.Homestead
residence? D ® 4.Solar Energy Heating or Goofing System
O p 2.Does the buyer have a homestead to be vacated 0 la 5.Wind Power Device
• for this residence? If yes,provide address: ' 0 ® 6.Hydroelectric Power Device
Address(number and street) ' D ® 7.Geothermal Energy Heating or Cooling Device
City.state.ZIP code,and county
26i1i- 2g1-400 - 001- 161i - 02\ .
?
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