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Homestead_Hudson H. PREPARER
Preparer of the Sales Disclosure Form Title
Courtney Pruett Title Clerk
Company
Address(number and street,city,state,country,and ZIP Code)
4600 Washington Ave, Suite 102, Evansville, IN 47714
I. SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Michael G. Lipscomb Rebecca D. Taylor
Address(number and street) Address(number and street)
1346 West Co Road 125 South 130 South 1st St.
City,State,and ZIP Code City,State,and ZIP Code
Petersburg, IN 47567 Elberfeld, IN 47613
Country Country
Email Address
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 6 felony.
-Signature of Seller rgn u of Setter r� t
Printed Name of Seller -ram I Date Signed(mm/dd/yyyy) Pri ed ame of Seller Date Signed(mMdd/yyyy)
Michael G. Lipscomb (.0),,I•a.cf Rebecca D. Taylor I a. a -aH
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
Megan Hudson
Address(number and street) Address(number and street)
10066 E Easy St
City,State,and ZIP Code City,State,and ZIP Code
Oakland City, IN 47660 - : A
Country Country `O'
28
Email Address
04,
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Idenfl_"j ghAbese that apply: r)
YES NO CONDITION YES NO CONDITION /',9 \ `)
V0 1.Will this property be the buyers primary ail/ 0 3. Homestead ��/�0,4
residence? 0 0 4.Solar Energy Heating or Codling System
0 2. Does the buyer have a homestead to be vacated 0 0 5.Wind Power Device
for this residence?If yes, provide address: 0 0 6. Hydroelectric Power Device
Address(number and street) 0 Q 7.Geothermal Energy Heating or Cooling Device
410 lv. (mess 0ri e
City State,and ZIP Code Count
Pa.►n I 449 t05 deoillb.11151 y 26- 13 - 23 -(oI -00I . 4g3 - v 0 6
3
y
•r C. y Mkt,.. ' IF
