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Homestead_Martin (4) 1 H. PREPARER Preparer of the Sales Disclosure Form Title Courtney Pruett Title Clerk Company Address(number and street,city,state,country,and ZIP Code) 4600 Washington Ave, Suite 102, Evansville, IN 47714 I.SELLER(S)/GRANTOR(S) Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on n • ' ;document + Vickie Ellis Address(number and street) .,�,,_ Address(number and street) # s l Dn '! r 1Y�t'Y t dv'1 E City,State,and ZI Code f ��)� City,State,and ZIP Code A,o I/ G�hsu l!1 1 t1 • 'y V 19 Zp Country Country 24 Email Address who knowingly and intentionally falslfle= , elue of transferred real property,or omits or fat ••q any Information required to be provided,commits a Level S felony. 5ignaC re f Seller /� Signature of Seller Printed a Iler Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy) Vickie Ellis I I-1 5'.2.-'4 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 Korey Martin Address(number and street) • Address(number and street) 505 S Main St City,State,and ZIP Code City,State,and ZIP Code Owensville, IN 4766 Country Country Email Address for certain deductions.Identify all of those that apply: YES NO CONDITION ` YES/, NO CONDITION ti 0 1.Will this property be the buyers primary l� 0 3.Homestead r sidence? 0 1 4.Solar Energy Heating or Cooling System o 2.Does the buyer have a homestead to be vacated 0 (7J 5.Wind Power Device for this residence?If yes,provide address: 0 0 6.Hydroelectric Power Device Address(number and street) 0 © 7.Geothermal Energy Heating or Cooling Device City,State,and ZIP Code County L_ 0^ \2^3o`l_coo. a Z_O,Z, . 3 \r" • ?