Homestead_Bartels H. PREPARER
Preparer of the Sales Disclosure Form Title
Kris Coon Closing Agent
Company
Address(number and street,city,state, country,and ZIP Code)
4600 Washington Ave., Suite 102, Evansville, IN 47714
I. SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on c e nce cument
123 W Morton St LLC
Address(number and street) Address(number and street 1
1)
City,state,and ZIP Code City,state,and, ode C' ?Q46,
?7
Country Country Q�C°c CQ,
USA tij: Q
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 Setleb Signature of Seller
QQ
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy) '
Dean Erickson (Q/14 �4--
J. BUYERS)/GRANTEE(S)—APPLICATIONFOR 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
Auriel Bartels
e3(nu r nd s_ treat
r )gAddress(number and street)
stale,and ZIP Co City,state,and ZIP Code
k-kCA-ti- Itt D'W S—KOLQ 0
Country Country
USA
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 V 0 3. Homestead
residence? OV 4.Solar Energy Heating or Cooling System
,�2. Does the buyer have a homestead to be vacated 0 B' 5.Wind Power Device
O for this residence? If yes,provide address: l]
0
Y 6. Hydroelectric Power Device.
Address(number and street) 0 fE)77.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county 2-C-- I I , _ ) % -
O -GO I 0-
O 0 4-
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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