Homestead_Durchholz H. PREPARER
—
Preparer of the Sales Disclosure Form Title
Milton Norman Settlement Agent
Company
Address(number and street,city,state,country,and ZIP Code)
25 NW Riverside Drive,Suite 310,Evansville,IN 47708
I. SELLER(S)/GRANTOKS) !
Seller 1-Name as It appears on conveyance document Seller 2-Name as appears on convey-, -- i o m
Shelly A.Patterson
Address(number and street) Address(number and street)
ItoW°1 1.-r: CS- (..".3r .3'1) Oei ,40
City,State,and ZIP Code City,State,and ZIP Code 0 9
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Country Country C3'461kS
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US
,.,_j -
Email Address
knowledge and belief,is true,correcand 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 property,or omits or falsifies any Information required to be provided,commits a Level 5 felony.
Signature of Sc -- Signature of Seller
Prints Znie . eller Date Signed(mm/ddlyyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Shelly A.Patterson 1 N-7),-41-1
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
Lvnell Joan Durchholz Robert William Durchholz
Address(number and street) Address(number and street)
r
Same
City,State,and ZIP Code City,State,andZIP Code
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Country Country
US US
Email Address
Pursuant to IC 6-1.1-12.44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary ( l 0 3.Homestead
DO O residence? 0 ri 4.Solar Energy Heating or Cooling System
0
2.Does the buyer have a homestead to be vacated 0 (2 5.Wind Power Device
. yno ..
ror this residence?If yes,provide address: 0 ( 6.Hydroelectric Power Device
Address(number and street) 0 ( 1 7.Geothermal Energy Heating or Cooling Device
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City,State,and ZIP Code X-2 /
, County "23 —OS 7300-4°02 }-38'-02-.4.,-,LiAni k //f el?b3-0 LeAtb,ri114,
Under penalties of perjury,I hereby thrtify that this Sales Disclosure,to the best of my knowledge and belief,Is true,correct,and complete
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