Homestead_Carlisle H. PREPARER
Preparer of the Sales Disclosure Form Title
Kris Coon Closing Agent
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 conveyance document
Jessica A. Smith II ( Kenneth W. Gonzales�` Y ' I V aJ�srfc \(may Ad• +rL. b ran stt00,1
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Country '` Country
USA
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 pro or omits or falsifies any formation required to be provided,commits a Level 5 felony.
Sign. f Seller SO. Signa/ture.of Seller . w
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Pay in Name of Seller Date signed(mm/d yy) Printed Name of Seller i r • .tr!'1'r•,fi.Tt!ryyyy)
essica A.Smith i j I 15 ,
J /-0,62 ,Kenneth W. Gonzales 117/cA20,r2 t-
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY A ]r�T�P
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Buyer 1—Name as It appears on conveyance document Buyer 2—Name as it appears on conveyance' docurtfen �
Jacob Carlisle . Carrie Carlisle Address(number and street) Address(number and street) %}�L� a. ��t
519 E Monroe St 519 E Monroe St
City,state,and ZIP Code City,state,and ZIP Code GIBSON L:UUN I Y AUDI!OH
Princeton IN 47670 Princeton IN 47670
Country Country
USA USA
E-mail address ' ,
YES NO CONDITION YES NO CONDITION
O O 1.Will this property be the buyer's primary O 0 3.Homestead
residence? 0 0 4.Solar Energy Heating or Cooling System
for this residence? If yes,provide address: 0 O 6.Hydroelectric Power Device
Address(number and street) 0 C) 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
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