Homestead_Boyd H. PREPARER
Prepororof the Sales Disclosure Form Title
Matthew Jon/iu Escrow Offic
er
Company
Address(number and otroot, city, otate, country, and ZIP code)
005 SE Martin Luther King JrBoulevard, Evansville IN United States nfAmerica 47713
i SELLER(8}/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as it appears on conveyance document
Shaine LEck Aho| C. Eck
Address(number and street) Address (number and street)
5U4M Polk St. 5O4N Polk St.
City, State and ZIP Code City, 81ota and ZIP Code
Fort Branch, IN 47648 Fort Branch, IN 47648
Country Country
United States nfAmerica United States ofAmerica
Email Address Email Address .�
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 Seller DGignat ofGa||
[-
Printed Name ofSeller Date Signed (mm/dd/ -Printed Name ofSeller Date Signed (mm1dd/yyyy)
Shaine L. Eck YYvY) Aria| C. Eck 7/17/2024
7/17/2O24
J. BUYER(G)/GRANTEE(S)—APPL|CAT|DN FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY
Buyer 1 —Nam000 it appears nn conveyance document Buyer 2—Name as it appears on
Trioton8nyd co
Address(number and street) Address (number and otranV 7 5O4N Pu|kS\. 1,kb ,
City. State and ZIP Code City, State and ZIP Code �93
��
Fort h |N 47O48 ~
o Branch, . *27
Country Country
United States of America
^u
Email Address
apply for certain deductions. Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
23 U 1. Will this property bm the buyer's primary residence? G8 U 3. Homestead
O G5 4. Solar Energy Heating or Cooling SY
O Xthis
2 D the b h homestead� be"^" � ~/~' ~` O E� 5. VWndPower Device `��'
d O Z 8. Hydroelectric Power Device ~'
Address(number and street) O ED 7. Geothermal Energy Heating or Cooling Device
�v~
City, Sto0a. and Z|P1���A/ ~ [c�- �� County
J ^
`~_~,��� ~—
Under penalties of perjury, | hereby certify that this Sales Disclosure,tn the best ofmy knowledge and belief,is true,correct,and complete
as required by|aw,and is prepared in accordance with |o V-1,1-5.s.x person who knowingly and intentionally falsifies the value of
Last Digits of Buyer 2/Gpouso O8N/Driver's Licanxe/|D/Othe '^ ' be