Homestead_Ayers (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Christa D.Tracey Escrow Officer
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
George Talbert Boop
Address(number and street) Address(number and street) pi
1566 S 950 E
•
City, State and ZIP Code City, State and ZIP Code
Oakland City, IN 47660 , ✓U� .. 1)
Country Country i�
United States of America 2(4
COtJc.
Under penalties of perjury, I hereby certify this Sales Disclosure,to the best of my knowledge and belief, is tr8& c ,and complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsi value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Signatur Seller Signature of Seller r-,),,,
Printed Name ofCler Date Signed (mm/dd/ Printed Name of Seller Date Sign d/yyyy)
George Talbert Boop YYYY)
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
Lauren Ayers Kendall Ayers
Address(number and street) Address(number and street)
1536 W. Shamrock Ct 1536 W. Shamrock Ct
City, State and ZIP Code City, State and ZIP Code
Bloomington, IN 47403 Bloomington, IN 47403
Country Country
United States of America United States of America
YE NO CONDITION Yr-NO CONDITION
❑ 1. Will this property be the buyer's primary residence? ❑ Homestead
0 ❑� /4�olar Energy Heating or C '`t,
.' -
�/ El 2. Does the buyer have a homestead to be vacated for ❑ m/S. Wind Power Device
this residence? If yes, provide address:
❑ 1:Q.16. ydroelectric Power Device
Address(number and street) 0 Q ll. Geothermal Energy Heating or Cooling Device
City, State,and ZIP Code County
. )\C t►4t'\ Jry WC ) a6 -13- 23 - Ic70-oo . c �I-oOC-
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
317 7 SJ`1pt-N 6—1 S-1