Homestead_Elliott H. PREPARER
Preparer of the Sales Disclosure Form Title
Christa D.Tracey Escrow Officer
Company
Address(number and street,city, state,country,and ZIP code) ,
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as it appears on conveyance document
Chelsea Voges
Address(number and street) Address(number and street)
1992 Bye Lane
City, State and ZIP Code City, State and ZIP Code44.%:4"
Milltown, IN 47145 ,
Country Country '4.,6 ?
United States of America ✓,Q 411
Email Address Address �c2 Telep umber
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belieY;ji'1 .+e,��««�,,orrect,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 e iu�ransferred real property,or
omits or falsifies any information required to be provided,commits a Level 5 felony. Nly �,
S' u eller Signature of Seller 40O,y
01
PrintedNam�eller Date Signed(mmtdd/ Printed Name of Seller Date Signed(mm/dd/yyyy)
Chelsea Voges `� yyyy) -
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
Jennifer Elise Elliott
Address(number and street) Address(number and street)
302 S Hillcrest St
City,State and ZIP Code City,State and ZIP Code
Fort Branch, IN 47648
Country Country .�'� 1 ,n
United States of America '!$ 3'
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
ICJ 0 1. Will this property be the buyer's primary residence? El 0 3. Homestead
0 El 2. Does the buyer have a homestead to be vacated for 0 El 4. Solar Energy Heating or Cooling System
this residence? If yes, provide address: 0 El 5. Wind Power Device
Address(number and street) ❑ El 6. Hydroelectric Power Device
❑ El 7. Geothermal Energy Heating or Cooling Device
City,State, and ZIP Code County t "-‘Ct-- l 1- tot_ aQ o . 0 9'- d G_C