Homestead_Havens H. PREPARER
Preparer of the Sales Disclosure Form Title
Stacey Salzman Settlement Agent
Company
Address(number and street,city,state,country,and ZIP Code)
2301 N.Burkhardt Road,Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on convey u t
Timara L.Boehme f/k/a Timara L.Bates
Address(number and street) Address(numberand street)
)
735 E.State St. ✓e/4/ '
/)
City,State,and ZIP-Code City,State,and ZIP Cod= 40,
Princeto
Country Country
IN 47670 --- Country C/esOti-• I��
US CO CC) .
Email Address
my knowledgaandlbelief,is true,cutlet,and complete as
required.by law,and is prepared in accordance with IC 6-1.1-5.5.A person w1q knowingly and intentionally falsifies the value of transferred
real property,or omits or falsifies any information required to.be provided,commits a Level 5felony.
SS natu Seller Signature of Seller
Name of Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Timara L.Boehme f/k/a Timara L.Bates 06/03/2024 06/03/2024
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
Austin C.Havens
Address(number and street) Address(number and street)
219 E.Locust St.Apartment D
City,State,and ZIP Code City,State,and ZIP Code
Boonville,IN 47601
Country Country
US
apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
•
® O 1.Will this property be the buyer's primary ® O 3. Homestead
residence? 0 ® 4.Solar Energy Heating or Cooling System
O ® 2. Does the buyer have a homestead to be vacated 0 al 5.Wind Power Device
for this residence? If yes, provide address: 0 ® 6. Hydroelectric Power Device
Address.(number and street) 0 IX 7.Geothermal Energy Heating or Cooling Device
•
City,State,and ZIP Code County i .- \7, —O"7_7 1., 1(,)'1 _--7
Under penalties of perjury,I hereby certify'that this Sales Disclosure,tothe'best of my knowledge and belief,is true,correct,and complete