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Homestead_Nolan H. PREPARER --- Preparer of the Sales Disclosure Form Title Milton Norman Settlement Agent Company Email Address Address(number and street,city,state,country,and ZIP Code) 25 NW Riverside Drive,Suite 310,Evansville, IN 47708 I. SELLER(S)/GRANTOR(S) • Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on co n document Kimberly A. Gooch (( Address(number and street) `` l Address(number and street) 12'cc\\---\ V\i\kic-k- 4 -41.., . City,State,and ZIP Code V)r"t ,1"S 'w.:U. City,State,and ZIP Code 4k Country L VQ r �l 3`'<1 i� Country G o,?,, US eSO Email Address Address �C/2 Telephone Mum er i✓ Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is true; .•; =ct,and complete as : required by law,and Is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and Intentionally falsifie• the value of transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. Signature of S J31er — - - _ Signature of Seller ,- L _� Printed/Tali-le—of of Seller �� Date Sig d(m /dd/yyyy) Printed Name of Seller Date Si ned mm/dd/ 9 ( yyyy) Kimberly A.Gooch '—i (---) !Z. f 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 Christina Ruth Nolan • Address(number and street) Address(number and street) f 118 W Pine St • City,State,and ZIP Code City,State,and ZIP Code Princeton, IN 47670 Country Country • US apply for certain deductions.Identify all of those that apply: YES NO CONDITION YES NO CONDITION 1.Will this property be the buyer's primary ® 0 3. Homestead ® O residence? 0 ® 4. Solar Energy Heating or Cooling System , 2. Does the buyer have a homestead to be vacated ® 5.Wind Power Device O for this residence? If yes, provide address: 0 ® 6. Hydroelectric Power Device Address(number and street) O 51 7. Geothermal Energy Heating or Cooling Device City,State,and ZIP Code County .-- 6 -12-(\T- Ir.T-nn ! , 1 - 028