Homestead_Kelley (9) _ ____ •
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r
PREPARER
-
parer of the Sales Disclosure Fom Title
rri Hudson Settlement Agent
Company Email Address
Address(number and street,city,state,country,and ZIP Code)
2301 N. Burkhardt Road, Evansville, IN 47715
I. SELLERS)/GRANTOR(S) {
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on conveya document
Shelby McFall
Address(number and street) Address(number and street) �
1 603 W.Pinkney St.
I City,State,and ZIP Code City,State,and ZIP Code
4 4 *.)
Princeton,IN 47670 �'4/{/,
Country Country � 6 }
US Q, , 204 c( I
Email Address
my knowledge and belief,is true* `and complete as
required by law,and Is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and Intentionally falsifiese ihp$Value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Signa f S I r � y n Signature of Seller
Printe Name Iler Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Shelby McFall 01/16/2024 01/16/2024
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
Andrew C.Kelley
Address(number and street) Address(number and street)
129 S.Seminary St.Apt.A
City,State,and ZIP Code City,State,and ZIP Code
' Princeton,IN 47670
Country Country
I US
! Email Address
for certain deductions.Identify all of those that apply:
YE NO CONDITION Y NO CONDITION
0 1. Will this property be the buyer's primary Cl 3. Homestead
residence? ) 4.Solar Energy Heating or Cooling System i
2. Does the buyer have a homestead to be vacated 0 ® 5. Wind Power Device
for this residence? If yes, provide address: 0 Cg 6. Hydroelectric Power Device
Address(number and street) 0 ® 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County
26-12- 0-7`301-- oo1. 5.31 - 07
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