Homestead_Cook --— — -r-.--.,
a H. PREPARER
Preparer of the Sales Disclosure Form l Title
Colleen Dunn I! Settlement Agent
Address(number and street,city,state,country,and ZIP Code)
2801 N 6th Street,Suite E,Vincennes,IN 47591 -_ -
I. SELLER(S)IGRANTOR(S) --. _---... ..
Seller 1 -Name as it appears on conveyance document
Seller 2-Name as appears on conveyance document
George H.Heacock Lorinda D.Heacock
Address(number and street) Address(number and street)
901 Chickasaw Drive 901 Chickasaw Drive
City,State,and ZIP Code City, State,and ZIP Code
Fort Branch,IN 47648 Fort Branch, IN 47648
Country CountryUS
US
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 Seller Signature of Seller
Date Signed mm/dd/ Printed Name of Seller sate Signed(mm/dd/yyyy)
Printed Name of Seller g ( YYYY)04/19/2024 Lorinda D. Heacock r. :/22024
George H.Heacock
J. BUYER(S)IGRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS4-FY ALL - .T APPLY
Buyer 1-Name as it appears on conveyance document l Buyer 2-Name as it appears r�y2nce document
Andrew D.Cook _ Natalie R.C • `Vl 1
(number -----)and street) Address(nurf �t)
Address Q
5498 Veranda Drive 5498 Veranda Driv U ddi
City,State,and ZIP Code City,State,and ZIP Code N�A(/O/Tp
Noblesville,IN 46062 Noblesville, IN 46062 R
' Country Country
US US
YES NO CONDITION YES NO CONDITION
propertybe the buyer's primary ® 0 3.Homestead
® O 1. idill this Y
residence? 0 ® 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 ® 5.Wind Power Device
O ® for this residence?If yes,provide address: 0 ® 6. Hydroelectric Power Device
i Address(number and street) 0 ® 7.Geothermal Energy Heating or Cooling Device
r
City,State,and ZIP Code County / - t i — `2 —lO 1 _ Oo�.Gt—7 C--O Z
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
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