Homestead_Halsne (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Courtney Pruett Title Clerk
Company
Address(number and street,city,state,country,and ZIP Code)
4600 Washington Ave, Suite 102, Evansville, IN 47714
I. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on cony ment
Allison A. Ehrenberg
Address(nummber and street) Address(number and street)
�!Jj
7/ tnlh,tto,,,Gy J✓+ 46>1 _
City,State,and ZIP Code City,State,and ZIP Code ✓UN
Al��/)v/�h l IV 4 765° g� �v/
Country Country jo
Email Address
-ivy ( )
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is tr •pyt,and complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally fats value of t
real property,or omits or falsifies any Information required to be provided,commits a Level 5 felony. /
c...)\
'Sign ure of Seiler a Signature of Seller
Printed Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(m dd/yyyy)
Allison A. Ehrenberg 5-at q_cit4
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1-Name as it appears on conveyance document 1 Buyer 2-Name as it appears on conveyance document
Michael Halsne
Address(number and street) Address(number and street)
501 W Mulberry St
City,State,and ZIP Code City,State,and ZIP Code
Princeton, IN 47670
Country Country
Email Address
apply for certain deductions.Identify all of those that apply:
t YES NO CONDITION YES NO CONDITION
VO 1.Will this property be the buyer's primary I� l 3. Homestead
residence? 0 O 4.Solar Energy Heating or Cooling System
O 2.Does the buyer have a homestead to be vacated 0 2 5.Wind Power Device
���rrr for this residence? If yes,provide address: 0 p 6. Hydroelectric Power Device
Address(number and street) 0 Q 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County 26 \2-O-/-'2 O3-O o I •/ Iy,Q- z
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,isl true,'correct,and complete
COPY