Homestead_Powell (2) H. PREPARER
iPreparer of the Sales Disclosure Form Title
, Leah Brown Settlement Aarent
Company
Address(number and street,city,state,country,and ZIP Code)
7820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715
I. SELLER(S)IGRANTOR(S) r
I Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on conve ce d rr4
7 Kaci Goforth I
Address(number and street) Address(number and street)JO
211 W Wamock Street ?/
City,State,and ZIP Code City,State,and ZA44ec, 4202c
kt
Princeton,IN 47670
Country Country
US
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 Seller i i A
•ic,,,,_,:, ,i1-1C.AV .,
Printed-Milne of Seller
Kaci Goforth
J. BUYER(S)/GRANTEE(S) —AP Signature of Seller
Date Signed(mm/ddfyyyyr Printed Name of Seller
07/15/2025 Date Signed(mm/dd/yyyy)
07/15/2025
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
Cloie Elaine Powell
Address(number and street) Address(number and street)
542 W 400 N
City,State,and ZIP Code City,State,and ZIP Code
Patoka,IN 47666
Country Country
US
( ) —
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
1.Will this property be the buyer's primary IR 0 3.Homestead
ati 0 residence? 0 M 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 M 5.Wind Power Device .
0 M for this residence?If yes,provide address: 0 M 6. Hydroelectric Power Device
Address(number and street) 0 12 7.Geotherrnal Energy Heating or Cooling Device
(
City,State,and ZIP Code County a Ai' 06 -30(.‘--c) z . 0 Gl\-0&3
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