Homestead_Cox (2) 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
Luke J. Dunn
Address(number and street) Address(number and street)
105 S Scott St.
City, State and ZIP Code City, State and ZIP Code
Owensville, IN 47665 ,
Country Country
United States of America
Email Address Email Address Telephone Number
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 property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Signature of t Ipr Signature of Seller
L '-.- .
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Luke J. Dunn 3-is-3 y
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
Isaac C. Cox
Address(number and street) Address(number and street)
2490 S Old State Rd 65
City, State and ZIP Code City, State and ZIP Code
�
Owensville, IN 47665 ,
Country Country d IX
United States of America 0
:1) --4- ''''er a
Email Address
apply for certain deductions. Identify all of tpmcggithat agsply:
YES NO CONDITION YES NO CONDITION ~'l Q 0
U
,Sk. 0 1. Will this property be the buyer's primary residence? X 0 3. Homestead z
0
0 II 4. Solar Energy Heating or Cooling cirktn cc0
0 •2. Does the buyer have a homestead to be vacated for °
this residence? If yes, provide address: ❑ �l 5. Wind Power Device
❑ p 6. Hydroelectric Power Device
Address(number and street) 0 6 7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county
— 18-0r— tol— COD. 5'/2— 01.-2_
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct and complete
_. 4,: