Homestead_Alcorn H. PREPARER �__ ---�---Preparer of the Sales Disclosure Form Title
Natalie Foley Settlement Agent
Company
Address(number and street,city,state,country,and ZIP Code)
25 NW Riverside Drive,Suite 310,Evansville,IN 47708
I. SELLER(S)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Daniel J.Toth
Address(number and street) 'r Address(number and street)
:.+a 3 c ' t b ley 14.440 G �J
City,State,and ZIP Code g,., N1U4 City,State, and ZIP Code
74(:)
`1`772a L
6
Country Country
US ✓(j/
Email Address
best of my knowledge WISJ -'i.- is true,correct,and complete
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and inte 01•I1c alIiDes the value of tra real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. 4' - .K '
zi
Signature of 5piip Signature of Seller y(/O/
^ CDR
Printed Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/d
Daniel J.Toth 07/01/2024 07/01/2024
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
Kelli N.Alcom Timothy Alcorn
Address(number and street) Address(number and street)
$Z'0?_ - •/ s `> Same
City,State,and ZIP Code City,State,and ZIP Code
Country Country
US US
Email Address
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
(Xi1.Will this property be the buyer's primary ® 0 3. Homestead
residence? 0 CKI 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 ( 5.Wind Power Device
for this residence? if yes, provide address: 0 al 6. Hydroelectric Power Device
Address(number and street) Q () 7. Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County
p6 -I fi - uz-3uu -uoL).38t ^0
z1
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
Page 3