Homestead_Horn .. . .
,
1 H..PREPARpl•- I
I Preparer of the Sales Disclosure Form Title
'Jeff Shoulders Attorney
Company
Address(number and street,city,state,country.and ZIP Code)
2405 N. Green River Road, Evansville, Indiana 47715
I. gELLER(S)/GRANTOR(S)
I
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Christopher Horn .
Address(number and street) Address(number and street)
3299 Forestdale Drive
1 City,State.and ZIP Code City.State,and ZIP Code
Newburgh, Indiana 47630
Country Country
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. I I
Sign of Seller Signature of Seller 'I
11 I
j (-70._/-•,757,4'-iff , I
I Printed Name ef Seller Date Signed(mm/dd/yyyy) Printed Name of Seller 'Y Date Signed(mm/dd/yyyy)
. I
I Christopher Horn <-. /2/ /70 2.3
I J. PUYER(OGRANTEE(s)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY Y
1 -I
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance documen
Heather Horn VA/ n
In
Address(number and street) Address(number and street) u ig g/25
; 910 Blackfoot Drive
City,State,and ZIP Code City.State.and ZIP Con, _
Fort Branch, Indiana 47648 'uSON en CZ.
Country Country UNA, 4,441)
I United States ir0
apply for certain deductions.Identify all of those.that epply:
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyers primary CI 0 3.Homestead .
0 0 ,
,
residence? 0 0 4.Solar Energy Heating or Cooling'System
2,Does the buyer have a homestead to be vacated 0 0 5,Wind Power Device
0 0 for this residence?If yes,provide address: 0 0 6. Hydroelectric Power Device
Address(number and street) 0 C) 7. Geothermal Energy Heating or Cooling Device
City.State.and ZIP Code County k2- ‘ - atoo co L
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,corre 4,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
II . _
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