Homestead_Banks H. PREPARER
Preparer of the Sales Disclosure Form Title
Kandace Rogers Closing Agent
Company
Address(number and street,city,state,country,and ZIP Code)
4905 Theater Drive, Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Hunter Steven Tackett
Address(number and street) Address(number and street
8315 South Strain Ridge
City,State Road
and ZIP Code City,State,and ZIP Code
Bloomongton, IN 47401
Country Country
USA Oci 2 4 4„„
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my k ellef,is true,correct and complete as
required by law,and Is prepared in accordance with IC 6-1.1-5.5.A person who knowl?n1 in, tliRalOifies the value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 fel 0..1, .e.ex.
Signa e o eller Signature of Seller
1-17-774V
Printed Name of Seller Date Signed(mat/cidlyyyy) Printed Name of Seller Date Signed(mmiciddyyyy)
Hunter Steven Tackett 10'1(0 -D LI
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
Taylor Banks
Address(number and street) Address(number and street)
8809 South Meadow Lane -
City,State,and ZIP Code City,State,and ZIP Code
Owensville, IN 47665
Country Country
USA
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-1 residence? ID El 3.Homestead
0
El 0 4.Solar Energy Heating or Cooling System
frf 2.Does the buyer have a homestead to be vacated Ei II 5.Wind Power Device
0 for this residence?If yes,provide address: 1:11 0 6.Hydroelectric Power Device
Address(number and street) D Z 7.Geothermal Energy Heating or Cooling Device
City,State,ZIP code,and County a,_ki - 2- t 10 o-o ol(.5l C—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 falsifies the value of
transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spouse's
,
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