Homestead_Seibert /' .
PREPARER
/ /reparer of the Sales Disclosure Form Title
l i Lana Harper Settlement Anent
i -
/
Company
Address(number and street,city,state,country,and ZIP Code)
25 NW Riverside Drive,Suite 310,Evansville,IN 47708
1.SELLER(S)/GRANTOR(S)
Seller 1-Name as It appears on conveyance document Seller 2-Name as appears on conveyance document
Jamie Jonas Michael Hammel,Jr.
Address(number and street) Address(number and street)
327 W.Vine St. 327 W.Vine St.
City,State,and ZIP Code City,State,and ZIP Code
Oakland City,IN 47660 Oakland City,IN 47660
Country Country
US •
US
Email Address
'
Under penalties of perjury,i hereby certify this Sales Disclosure,to the best of my knowledge and ballef,Is this,correct,end complete as
required by law,and Is prepared In accordance with IC 6-1.14.5.A person who knowingly end Intentionally falsifies the value of transferred
real property,or omits or falsifies any Information required to be provided,commits a Level 5 felony.
ture of Seller r4.____ 00 i ,
Signature of SeIIFr o �
Prfpted Name of Seller , 1 Data Signed(mmld ) Printed Name of Seller Da )
Jamie Jones 1J Igi„2•Go Michael Hammel,Jr. �J. BUYS s/GRANTEE S -APPLICFOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1-Name as It appears on conveyance document Buyer 2-Name as it appears •.., : : document
Cvrenna Seibert
Address(number end street) Address(nu ),
327 W.Vine St 15Li}
City,State,and ZIP Code City,State,and Code
Oakland City,IN 47860 tv�l I
Country p\'cO�Coup �Y
US Email Address '"-C.0 Pv Telephone Number
Email Address
apply for aertsin deductions.Identify all of tho apply:
YES CONDITION YES NO CONDITION
® 0 3.Homestead ,4)
0 1.Will this property be the buyer's primary ��,
residence? 0 OD 4.Solar Energy Heating or Cooling S m
2.Does the buyer have a homestead to be vacated 0 53 5.Wind Power Device
e(
for this residence?if yes,provide address: p 12 B.Hydroelectric Power Device
Address(number and ) /!I Q ( 7.Geothermal Energy Heating or Cooling Device
State,and ZIP Code �•, Cots*-ksv ,11/ ''??/y
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