Homestead_Hill (4) H. PREPARER
Preparer of the Sales Disclosure Form Title
Kris Coon Closing Agent
Company
Address(number and street,city,state,country,and ZIP Code)
4600 Washington Ave., Suite 102, Evansville, IN 47714
I.SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Peony Investments LLC
cJre rt`ttti�el{a(�d sf`et,-e if
c Address(number and street)
Ci •sta�l�and Z P Code
City,state,and ZIP Code
� " r ON `�'�1111.
Country 44)1
'� Country 00i
USA USA �J (f
hereby certify this Sales Disclosure,to the best of my knowiedF+.,diliP s 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 Ifalsifies the value of transferred
real pr ,or omit or fal ifies any information required to be provided,commits a Level 5 felony:4(i •
C tur of S „pf _ Signature of Seller 749
Pri fir . fSeller / Date si a (mm/ yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
K ly . Gibson, J ( , , j-, J�
J. BUYER(S)/GRANTEE(S)—APPLICATI N F R PROPE TY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document
Ethan Hill
Address(number and street) Address(number and street)
110 S Lincoln Ave
City,state,and ZIP Code City,state,and ZIP Code
Oakland City, IN 47660
Country Country
USA USA
NO CONDITION
0 1.Will this property be the buyer's primary O 0 3. Homestead
residence? 0 Cl 4,Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 C) 5.Wind Power Device
0 for this residence?If yes,provide address: 0 O 6.Hydroelectric Power Device
Address(number and street) 0 CI 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county 24—)(,k.- t f -403`bon-630,0c
4.