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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