Homestead_Evans IH. PREPARER
Prdparer of the Sales Disclosure Form Title
Abbigail Jarvis 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
1. SELLER(S)IGRANTOR(S) d Seller 1 —Name as it appears on conveyance document Seller 2—Name as it appears on convey u nt
Estate of Ruth A. Kamman,deceased 1
Address(number and street) Address(number and street)
738E 1025 S ' tij
001
City,State and ZIP Code City,State and ZIP Code l
Haubstadt, IN 47639 1 2024
Country Country G/$�
United States of America O• 4:'COQ
Email Address
0�r�h
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,or omits or falsifies any information required to be provided,commits a Level 5 felony.
rS' nature of S I er Signature of Seller
Printed of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Jeffrey D. Kammam, Personal 10/1/2024
Representative
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
Mitchell Evans
Address(number and street) Address(number and street)
11556 S 150 W
City,State and ZIP Code City,State and ZIP Code
Haubstadt, IN 47639
Country Country
United States of America
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 YE9- NO CONDITION
4�'/ 0 1. Will this property be the buyer's primary residence? V 0 3. Homestead
0 El 4. Solar Energy Heating or Cooling System
0 /2. Does the buyer have a homestead to be vacated for this ❑ E 5. Wind Power Device
residence? If yes,provide address:
0 El 6. Hydroelectric Power Device
Address(number and street) 0 2 7. Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County �`C1 S Z_ (O` - p 0 O S, "l _02.
Under penalties of perjury,I hereby certify that 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 falsifi :. a value of
transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Nee: ouse's
information,SSN/Driver's License/ID/Other Number is necessary if a Homestead Deduction is being filed.)