Homestead_Gates H. PREPARER
Prepa;er 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
James L. Bethel
Address(number and street) Address(number and street)
901 E State St.
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670 ,
Country Country
United States of America
Email Address
Under penalties of perjury, I hereby certify 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.
Signature of , Signature of Seller
Printed N e of Seller ' Date Signed(mm/dd/ Printed Name of Seller Date Signed(mm/dd/yyyy)
James L. Bethel YYYY) ir�'0 • r /
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 ahi1
ears on conve ance document
Logan Gates Fs
1, _ _Address(number and street) Address(number E
_,
S CoCky r\.Sc,,,,1 .
City, Sta �annd ZIP Code City, State and ZIP CorkN 18 2024
Country Country
apply for certain deductions. Identify all of those that apply:
YES NO CONDITION YE,S� NO CONDITION
❑ . Will this property be the buyer's primary residence? � ❑/3. Homestead
❑ ❑ 4. Solar Energy Heating or Cooling System
❑ 2. Does the buyer have a homestead to be vacated for 0 5. Wind Power Device
this residence? If yes, provide address:
❑ 0 6. Hydroelectric Power Device
Address(number and street) 0 Le 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County
&-7o2--D g-- /0 UCH,a•5 80-0c3-0
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