Homestead_Kiesel (16) H. PREPARER
Preparer of the Sales Disclosure Form Title
Crista A.Wallace Title Assistant
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
Thomas J. Kesel and Rebecca A. Kiesel Revocable Living Trust Thomas J. Kiesel and Rebecca A. Kiesel Revocable Living Trust
Address(number and street) Address(number and street)
6876 S 50 W 6876 S 50 W
City,State and ZIP Code City,State and ZIP Code
Ft. Branch, IN 47648 Ft. Branch. IN 47648
Country Country
USA USA
E-mail address ,
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 informationX
required to be provided,commits a Level 5 felony. ����//�
Signature of Seller f) Sign re f Seller ?f', �'�-GC
Printed Name of Seller Date si ned(mrn/dd/yyyy) Printed Name ogee / l Date signed(mm/dd/yyyy)
Thomas J. Kesel and Rebecca A. Kiesel Thomas J. Kiesel and Rebecca A. Kiesel I
Revocable Living Trust - l4 --/, — 2 / Revocable Living Trust 0 (fba ,)-V2._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
Chester J. Kiesel
Address(number and street) Address(number and street)
6876 S 50 W
City,State and ZIP Code City,State and ZIP Code 7-
Fort Branch,IN 47648 . .N
Country Country IX
apply for certain deductions.Identify all of those that apply: r--r N'z
YES NO CONDITION YES NO CONDITION r c O
mli
El 0 1. Will this property be the buyer's primary residence? El 0 3. Homestead ^ . Z
❑ El 4. Solar Energy Heating or Cooling SysterF T O
❑ CZ 2. Does the buyer have a homestead to be vacated for this ❑ RI 5. Wind Power Device rid m
residence? If yes,provide address: J�
❑ 6. Hydroelectric Power Device 3I 1
Address(number and street) ❑ El 7. Geothermal Energy Heating or Cooling Device
City,State,ZIP code,and county /��
2& -1 V}/��-' 3- 2.0c• co .... ,�..1-L 3- 0025
5
Under penalties of perjury,I hereby certify that 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.(Note:Both spouse's