Homestead_Avila H. PREPARER
Preparer of the Sales Disclosure Form Title
Abbey Moore Closing Agent
Company
Address(number and street, city,state, country, and ZIP Code)
4905 Theater Drive, Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Jamie L. Bruce James L. Pohl
Address(number and street) I de r s trumber and street)
City, a.te,and Z Code ^ Ci Stat nd ZIP Code
o.-L f--12-kC k--, �, y�c� V �' � a�lC/f, ICJ ({7( �f
Country Country
USA USA
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. party,or omits or falsifies any Information required to be provided,commits a Level 5 felony.}( ‘
S• \gnatu of Seller S.ty'f.tore of Seller
Pript� ame of Seller Date Signed(mm/dd/yyyy) P ed Name of Seller Date Signed(mm/dd/yyyy)
Ja L. Bruce 12/18/2023 James L. Pohl 12/18/2023
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
J Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on veyance document
N Pablo De Los Santos Avila
Address(number and street) Address(number and street)
Fa 608 North Race Street 4144
0 City,State,and ZIP Code City,State,and ZIP Code n V!
Princeton, IN 47670 FC
Country
USA
G/ 910�
(
YES NO CONDITION 0/T0 )
N 1.Will this property be the buyer's primary ES El /3. Homestead R I�)_71
El1,1i
residence? ❑ C 4.Solar Energy Heating or Cooling Sy
r 2. Does the buyer have a homestead to be vacated El5.Wind Power Device
9 for this residence? If yes, provide address: ❑ 6. Hydroelectric Power Device
JAddrlass(number and street) ❑ 7. Geothermal Energy Heating or Cooling Device
City,State,ZIPffode,apd Court(+ r e
O ,V 6�17cE 5/ fINk ProN IN -6-1q -- (p -3 0 2 -00 0. 036 - o2C
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