Homestead_Fugate H. PREPARER
Preparer of the Sales Disclosure Form Title
Claire Kincaid Settlement Agent
Company /�
4799 Rosebud Lane,Newburgh, IN 47630
I. SELLERS)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Timothy A.Gaines Jonathan P.Gaines
Address(number and street) Address(number and street)
203 S.Third St.
City,State,and ZIP Code City,State,and ZIP Code
Owensville,IN 47665
Country �
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
property,or s or falsifies any information required to be provld d otnmlts a Level 5 felony.
i nature eller f re of Seller
ed Name of Seller Date Signed(mm/dd/yyyy) 4) Name of Seller Date Signed(mm/ddlyyyy)
Timothy A.Gaines 09/15/2023 nathan P.Gaines 09/15/2023
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY T AP Y
Buyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appears on conveys um
Shelby J.Fugate
Address(number and street) Address(number and street) No ? �VVJ
204 E.Warrick St. Q 202
3
City,State,and ZIP Code City,State,and ZIP Code
OwCouernille, IN 47665 try Country G/eON CO/
US
certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
XO 1.Will this property be the buyer's primary 0 3.Homestead
residence? 0 0 4.Solar Energy Heating or Cooling System
O 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) 0 ® 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County
a-11- 12,-1-02-Opo .143s -o ZZ