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Homestead_Hurt H. PREPARER Preparer of the Sales Disclosure Form Title Allyn Tresenriter Escrow Officer Company Address(number and street,city,state,country,and ZIP Code) 7412 Eagle Crest Blvd Evansville, IN 47715 I. SELLER(S)/GRANTOR(S) Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document Robert G. Golden Linda L. Golden Address(number and street) Address(number and street) SNC101(JUIN OGli:C 15111 ' D\Es145/[k RCA LOH Shack.) k_oint Ocas IST11 1-tuiest--A ad Lof-I4 Cty,state,and ZIP Code City,state,and ZIP Code 2kLeM‘M aVe ir C L, n'l kt)o c tea v wca-l-e r rt_ wie 0 , Country Country US US _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 re. property,or omits or falsifies any information required to be provided,commits a Level 5 felony. ig :. reel Selerg Signat e of Sell t)U di 1 I ‘,..0,----- w Printed Name of Seller Date signed(mm/ddlyyyy) ' te' am of Seller - late signed(mm/dd/yyyy) Robert G. Golden 08/29/2024 Linda L. Golden 08/29/2024 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 Nancy Jean Hurt Address(number and street) Address(number and street) 5945 E 390 N pi3 City,state,and ZIP Code City,state,and ZIP Code - kb Francisco, IN 47649 Country Country Sep US US • cu2,4 for certain deductions.Identify all of thoseqtra1044:. YES NO CONDITION YES NO CONDITION 'Olio I.Will this property be the buyer's primary E 0 3. Homestead CI 0 residence? 0 0 4.Solar Energy Heating or Cooling System ,IX 2. Does the buyer have a homestead to be vacated 0 0 5.Wind Power Device 0 for this residence? If yes,provide address: 0 0 6. Hydroelectric Power Device Address(number and street) 0 0 7.Geothermal Energy Heating or Cooling Device /City,state,ZIP c de,and county 2.6 —61---/S"--24 3-0D0,ipro4-eo 7