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,: