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Homestead_O'Conner IH. PREPARER _ Pre parer of the Sales Disclosure Form u Title K Gina Gruse Closing Agent Company Address(number and street,city,state,country,and ZIP Code) 6402 Railroad Avenue, Crestwood, KY 40014 USA I. SELLER(S)/GRANTOR(S) _ Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyanc- • men Cartus Financial Corporation al . Address(number and street) Address(number and slreet) ro,, 4. - ' 100 Reserve Road _ ?z y�j City, State,and ZIP Code City,State,and ZIP Cod `0�3 /- )-: Danbury, CT 06810 /es Country -- Country Oh,CO i . '/_.. • USA _ •L�, ( R) i 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 1. and is prepared In a brdance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred real prope .or omits or falsifies a information required to be provided,commits a Level 5 felony. -- .J,:Seller ; Signature of Seller Printed erne of Seller Date Sign (r-rmlddly y) Printed Name of Seller Date Signed(mrnldd/yyyy) • Cartus Financial Corpora ion If (- O' J. BUYER(S)IGRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY Buy @ 1,Name as it wpears on conveyanc .document Buyer 2-Name as it appears on conveyance document Address(numtr and street) Address(number and street) 6': `7 1; Pies y Li-)6 City,State,and ZIP Code City,State,and ZIP Code rv-;,tee, lie, i •1 !() L I Z'7 / Country,(� Country Email Address ( ) t 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 f YES NO CONDITION 1.Will this property be the buyer's primary U 0 3. Homestead CO O residence? O Op 4. Solar Energy Heating or Cooling System O O 2.Does the buyer have a homestead to be vacated 0 2) 5.Wind Power Device for this residence? If yes,provide address: 0 © 6. Hydroelectric Power Device Address(number and street)F. - O n 7.Geothermal Energy Heating or Cooling Device City,State,and ZIP Code County � -I -I p _ 3 c2-002 110 _ 0 2 O , (o L 3 O � ` e. %t,,,,y- ii,-,-.0 y Al