Homestead_Brown (4) H. PRERARER
Prepaverof the Sales Disclosure Form TlUo
Shannon Valiant Escrow Officer
Company
Address(number and street, city,state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
|. SELLER(G)/GRANTOR(S)
Seller 1 -Name ooit appears on conveyance document Seller 2-Name ooit appears on conveyance document
Ann D. Gtoggu FIL
Addroos(numberandstrnn0 Addreuo(numbnrandotnee�1OOS.JommyGt
City, 8�o�eondZ|P Code
\� City, State and ZIP Code
Haubotadt. |N 47638 '�> \� \\ ' . v�/ oi
, ^,
Country Country
^
United States ofAmerica c�7
Email Address
'
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
real property,oromits or falsifies any information required tobp provided,commits Level 5felony.
Signature ofSeller �l (�{ ^ /� /�] Signature ofSeller
�~°° ^-� ' '~' --)Y 0-
PrintedNamenfSo||a, Date Signed (mm/ud/ Printed Name ofSeller Date Signed(mnxdV/yyyy)
Ann D.Stoggo v;vv)
Q/3O/2O24
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1 -Name oait appears on conveyance document Buyer 2-Name onit appears un conveyance document
JonodN|. Brown Cheryl G. Brown
Address(number and street) Address(number and street)
1OO47G. Partridge Ave. 10O47S. Partridge Ave.
City, State and ZIP Code City, State and ZIP Code
Haubatadt. |N 47639 Houhotadt' |N 47639
Country Country
^ United States ofAmerica United States ofAmerica
rJ Email Address
(
�
Zr Pursuant to|C 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions. Identify all of those that appjy4r��
e)
YES NO CONDITION YES NO CONDITION
`
^ U 1 VW||thioppopu�ybethebuyer'nprimaryioxidence? -�� O �. Homestead
. ~ �
ElI] 4. Solar Energy Heating or Cooling System
O 2. Does the buyer have ahomo�uodh»bn vacated for O u^ 5. VWndPower Device
I - this residence? If yes, provide' �0 El _ G. Hydroelectric Power Device
Address(number and otreo� O �� 7. Geothermal Energy Heating nr Cooling Device
� �QO4O S . ���4C���� PNE�
City. State,and ZIP Code County VoNkec>wf� I P 4-l(0 Y) (A rns��ra
Under penalties nf perjury,|horobyxertifythot this Sales Disclosure,to the best of my knowledge and belief,is true,correct,and complete
~~ os required by law,and i^prepared in accordance with|C 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of��ml transferred real property,nr omits nrfalsifies any information-required to he provided,commits ito a Level sfe
lony. yVotv:Both spouse's
SSoD�, ' L/c eVIV0therNunbor/sneoeoaary/faHonoameadDeducbnn/sbe/ng��dl