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Homestead_Moody (5)
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. SELLERS)/GRANTOR(S) Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on convey ment William Brent Schafer �� 77 A drb6r_aqd at .\ O� �'�C Address(number and street) k:40 st e,@Pd,��Cgd@ , r ( City,state,and ZIP Code /yAp Country I`V �J �J Country �trr /8 q/25 USA USA 0 6),., E-mail address address ON�{� Telp'hone number Under penalties of perjury,I hereby certify this Saes Disclosure,to the best of my knowledge and belief,is true,19-. ; ' -.,' omplete as required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies I •& 4.re of transferred real property,or omits or falsifies any required to be provided,commits a Level 5 felony. Signature gfpeller,.--7 G' --h Signature of Seller , Printed Name of Seller I Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy) William Brent Schafer s ,:(-- 2—/ 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 Breean H. Moody Alexander C.Sagers Ad\r�sjnprib ran trit)� p PO � Address(number and sty et) City, ari hed ZIrP{•.. �' h )IQ[�0 0 City,state,and ZIP Code Country Country USA USA CONDITIONii, YES NO CONDITION 1.Will this property be the buyers primary 0 3.Homestead O residence? O V 4.Solar Energy Heating or Cooling System O Does the buyer have a homestead to be vacated 0 ( 5.Wind Power Device for this residence? If yes,provide address: 0 IY :Hydroelectric Power Device Address(number and street) 0 [13" 7.Geothermal Energy Heating or Cooling Device City,state,ZIP code,and county 1 '1-203 —00 © , SD ' ry 5 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 Page 3 of 5 .; - 0. ' '. 4' .t