Homestead_McClanahan I H. PREPARER
Preparer of the Sales Disclosure Form Title
J Amy B. Perkins Settlement Agent
Company
Address(number and street,city,state,country,and ZIP Code)
{ 7820 Eagle Crest Blvd,Suite 201, Evansville, IN 47715 i
I. SELLERS)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on con a c o ent
Ethan W.Harrolle
Address street)and
(number Address
d ess(number and street)
104 E Strain Street ✓j,/ 41)
City,State,and ZIP Code City,State,and ZIP Cod. VC J2
Fort Branch, IN 47648 �Q 1
Country Country '7
US
best of my knowledge and belief,is true,corr6et,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.
SignalSel�ei Signature of Seller
•
--Printed Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Ethan W. Harrolle 07/12/2024 07/12/2024
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
Katie Rene McClanahan
Address(number and street) Address(number and street) i
13 W. Red Bank Rd.
City,State,and ZIP Code City,State,and ZIP Code
Fort Branch,IN 47648
Country Country
'.
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:
1 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 O 2. Does the buyer have a homestead to be vacated 0 NI 5.Wind Power Device
for this residence? If yes, provide address: p a 6. Hydroelectric Power Device
Address(number and street) O ® 7. Geothermal Energy Heating or Cooling Device
� I
11\• City,State,and ZIP Code County
3