Homestead_Boelens 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. SELLERS)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on con nce oc ent
Chris Bacchi
Address(number aqd street) Address(number and street)
City,"2,(A S , L. i Y1 C 0\r S 1-. 0 2 6(-( se- , 411
P
y,state,and ZIP Code C� City,state,and ZIP Code 1
ry r c\f`�r V C 6� ° Country 0/6, O�7
Count ////
US US c00.
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
real' roperty,or omits orfal any information required to be provided,commits a Level 5 felony.
Si of Selleb Signature of Seller
Print m. of Se11ef V 1 oDate (mm/signed
g dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Chris Bacchi 09/11/2024
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
Sidney C. Boelens
Address(number and street) Address(number and street)
827 Jefferson Avenue;APT C
City,state,and ZIP Code City,state,and ZIP Code
Evansville, IN 47713
Country Country
US US
YES NO CONDITION
O 1.Will this property be the buyer's primary O 0 3. Homestead
residence? O O 4. Solar Energy Heating or Cooling System
O O 2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
for this residence?If yes,provide address: O O 6. Hydroelectric Power Device
Address(number and street) 0 Q 7. Geothermal Energy Heating or Cooling Device
City,state,ZIP code,an county
ap—I (- 173_ 2fla.au Q (q0- 0 �s .