Homestead_Hamm (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Jamie E. Smith Escrow Officer
Company
Address(number and street,city,state,country,and ZIP Code)
101 Plaza East Boulevard, Suite 102, 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
Travis Bottoms
Address(number and street) Address(number and street)
ill Ll4s E -700 S -
City,State,And ZIP Code ,�^ [ 1� /` City,State,and ZIP Code
Country
rylQn l�1ZtA -� '"►/oGv Country
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, isifies any Information required to be provided,commits a Level 5 felony.
S at S Signature of Seller
nted Name of Seller Date Signed(mm/ddiyyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)u
Travis Bottoms October 17,2024 rite
17,2024
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTI L THAT APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears o n y current
Patty Hamm
-161
Address(number and street) Address(number and street)
aatb Gft A-6-D 2 Oe
City,Stale,and ZIP Code City,State,and ZIP Code C ,
)i /4i)Jt ,J11 4-15(14s ! e024
Countnis Country
1U�1 O
apply for certpin deductions.Identify all oitp;`l�tirat apply:
YES NO CONDITION YES O CONDITION �1
❑ 1.Will this property be the buyer's primary ❑ 3.Homestead
r sidence? ❑ �4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated El ❑�,5,Wind Power Device
El
this residence?If yes,provide address: ❑ D Hydroelectric Power Device
Address(number and street) ❑ i7.Geothermal Energy Heating or Cooling Device
City,State,ZIP code,and County ^1 �r, -ZOO
7OO-OO 0 °o -. 006
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
Information,SSN/Driver's License/ID/Other Number Is necessary only if a Homestead Deduction Is being Med.)
k +��