Homestead_Milam •
•
H.FRt PARER:. ; . , . . . - •
Prepater of the Sales D)s-cdosut'a Form Tide
Milton Norman Settlement Aoent
Company
Address(number-and street,•clty,state,country,and ZIP Code)
25 NW Riverside Drive,Suite 310,Evansville,IN 47708
`I..$ELLER(S)IGRitt R{S)
•
Seller'. Name as kappearson conveyance document Seller a—Name as appears on conveyance document ,
Jamie King Audra King
Address(number and Street) Address(number and street) .
300 W Locust St 300 W Locust St '
City,State,and ZIP Code City,State,and ZiP Code '
Fort Branch,IN 47648 Fort Branch,IN 47648
Country Country
US US
ErnaltAddress
Under penelk 'r 'r> j h mby:s ilify: wile Dlsdoau to the belst�of my knowledge and'belief,is true,correct,and complete.as
mqutrad bylaw,and Is;prspeo+ed fn:a'ccarda'lnci-With,IC 6=1,1.5 5:A'Orton who knowingly.•endlntentlonally falsifies the value of transferred:
O.od ptopar`ty,or.Anita;orfalsiffee any rnfomiatloni qui; te'be Provldad,ocommitha 1-avel,5•felony. •
Signature of Seper�. _ Signal re of Seiler ` %
iName•of.Seller •Date•Slgned.(mmldd/yyyy) PrintName ofSeller --AY.) Date Signed(mmldd/yyyy)
e King !• Audra Kin t
BUYER(S.)/GRAN (SI l!;APPi;XCAT.ION F R 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
Jonathan Milam
Address(number end'skreet) Address(number and stes
300 W Locust St
'City,State,and ZIP Code City,State,and ZIP Code -�
Ft Branch, IN 47648
sCountry country DEC 1 3 ?04
Email Address
O� ( )
Purs 1'itlto %�B=1:t='1 ;44;tha; aitt#s.Diecliseirre.Forrn.•nray tie,used to appfyfidr'cei#adrr v,.. • of those thatnPPlY:
YES NO CONDITION YES NO CONDITION,. T)'
v Au,,,,_.
® 0 1.W,iill tfils property be INbuyer's primary .® 0 3.Homestead
residence? 0 ® 4.Solar Energy Heating or Cooling System
O O 2,Does the.buyer have a homestead to be vacated 0 ® 5.Wind'Power Device
for this.reSide'nce?if yes,'pr+ovide.address: p i 6.Hydroelectric Power Device
Address{number and street) 0 III 7.Geothermal Energy Heating or Cooling Device
CttyeStafe,and ZIP Code County • ��
26- 1 �8 - i3� 3 . uno. 131-bZ- .
Last 5Digits of Buyer'2/Spouse SSN/Driver's UcenseflD/Other Number
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