Homestead_Meyer H. PREPARER
Preparer of the Sales Disclosure Form Title
Shannon Valiant 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 -
Nancy E. Leukhardt
Address(number and street) Address(number and 1e1TL ED
403 E. Mulberry St.
City, State and ZIP Code City, State and ZIP Co e
Fort Branch, IN 47648
Country Country FILE 3 ^.
United States of America � p
Email Address
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I� N tr 1JNTY AUCITOR
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledg�"and%else , is true,correct and complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowing ArpWiti6haily fai,Sjfies the value of transferred
real property,or omits or falsifies any information required to be provided,commits a LAY 1@t►ytjNfY AUDITOR
Sg is of Seller e y,_�n t„) Signature of Seller
Printed me of Iler ( N Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Nancy E. Leukha dt 12/1/2023
J. BUYER(S)/GRANTEE(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
Alex Meyer Bryan Meyer
Address(number and street) Address(number and street)
11488 S 150E 11488 S 150 E
City, State and ZIP Code City, State and ZIP Code
Haubstadt, IN 47639 Haubstadt, IN 47639
Country Country
United States of America United States of America
YES NO CONDITION YES NO CONDITION
0 1. Will this property be the buyer's primary residence? 0 3. Homestead r
0 4. Solar Energy Heating or Coo i• Sy
❑ 2. Does the buyer have a homestead to be vacated for 0 6;9 5. Wind Power Device
this residence? If yes, provide address:
❑ ® 6. Hydroelectric Power Device
Address(number and street) 0 �] 7. Geothermal Energy Heating or Cooling evice4
City, State,ZIP code, and county
.76-r9-- lq_ to( - cam, 6 cot -o,)-G
Under penalties of perjury,I hereby certify that 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 property,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spouse's
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