Homestead_Buck 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.SELLERS)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2--Name as appears on vey c docu—nt
Mike J. Hulfachor
Address(number and street) Address(number and street)
5073 N 200 West
City,State,and ZIP Code City,State,and ZIP C de
Patoka, IN 47666 '025
Country Country C'/49
O
`1Vi ,r�of
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,or omits or falsifies any Information required to be provided,commits a Level 5 felony.
Signature of Sell r . Signature of Seller
—
3t//kVAtif 1L--`.`---
Printed Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Mike J.Hulfachor November 8, 2024 November 8, 2024
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
Victor E. Buck
Address(number and street) Address(number and street)
5073 N 200 West
City,State,and ZIP Code City,State,and ZIP Code
Patoka, IN 47666
Country Country
for certain deductions.Identify all of the e that _'ply:
YES NO CONDITION Yge, NO❑ CONDITION
❑ 1.Will this property be the buyer's primary Homestead
residence? ❑ E4.Solar Energy Heating or Cooling System
. Does the buyer have a homestead to be vacated ❑ d 5.Wind Power Device
❑ LL__I for this residence? If yes,provide address: ❑ d .Hydroelectric Power Device
Address(number and street) ❑ L'J 7.Geothermal Energy Heating or Cooling Device
City,State,ZIP code,and County
— 14 — too- 002 . tog - 13 .
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 6-1.15.5.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