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Homestead_Conder
H. PREPARER Preparer of the Sales Disclosure Form Title Leah Brown Settlement Agent Company Address(number and street,city,state,country,and ZIP Code) 7820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715 I. SELLER(S)/GRANTOR(S) Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears •, c nv a document Chance L.Cook Address(number and street) Address(number and street) 111 S Cross Street 0C/ 44. City,State,and ZIP Code City,Slate,and ZI Code l o Francisco,IN 47649 Country Country Gies, S US 04/c.O Q Email Address NI , �� Email Address viy Telephone Number Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is truQ, orrect,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,or omits or falsifies any information required to be provided,commits a Level 5 felony. Signature f'Seller Signature of Seller Printed Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy) Chance L.Cook 10/03/2024 10/03/2024 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 Chance L.Conder Sabrina M.Conder Address(number and street) Address(number and street) 10166 Illinois St. 10166 Illinois St. City,State,and ZIP Code City,Stale,and ZIP Code Oakland City,IN 47660 Oakland City,IN 47660 Country Country US US Email Address N ,^ - certain deductions.Identify all of those that apply: YES NO CONDITION YES NO CONDITION ® ❑ 1.Will this property be the buyer's primary CZ 3. Homestead residence? 0 ® 4. Solar Energy Heating or Cooling System ❑ 2. Does the buyer have a homestead to be vacated 0 [25.Wind Power Device for this residence? If yes, provide address: ❑ ® 6. Hydroelectric Power Device Address(number and street) ❑ 2 7. Geothermal Energy Heating or Cooling Device City,State,and ZIP Code County 2 ,1 3— �iJ` - 10I —©o0, v21 -dog Page 3