Homestead_Ellsworth Preparer of the Sales Disclosure Form Title
Katie Felty Escrow Officer
Company
Address(number and street,city,state,country,and ZIP Code)
7412 Eagle Crest Blvd Evansville, IN 47715
.74141:0,-E00)70, TiARMAik.H.iit-Ati1.'.4:.'„:;,1;4.1. -,-':4;,:.4::1',:i.j'':!2:;:.'::::::',::- .::',-1:.:ii. /,,i .-;:-:•',.i:6,;,i,T - r.:.-:. -. .t.:;'a:::':::'...::'-':.:'.72ITO: .:''IZU::.:Vilr:: -.-7
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Jerry R. Bates
Address(number arid ptreet) i Address(number and street)
11035 AD us I-Ly Li i
City,state,and ZIT Code. City,state,and ZIP Code
1)01, .et ATTek *r--A/11 4 1 U iii(9
Country Country
US US
rotiil,Iiii(gaws4-4-0-ofirgiokai to26..iaiiittroaitrei4-si-Rweirraw::
.44,,,,,,o,,,401074wioodfrivre,001-146,a,p-Avoidev#60.64";5**toit.00014-4.4-10-0Ahkgiiitenvollakfoortaithik,aloroittofetio,„
•i9at ofpoTowitorgiottgitwono#9,040.9.0tqaotioff4A4roiogiaoiirittoufgo,foolir -,.
SI nature eller Signature of Seller
. c•It'14‘;" -.
• ed Nam Seller Date signed(mm/daVyyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Jerry R. Bates 7/16/25 •
iiiatiNit irt.0*A. fatilij47.0.0,35.0ii,iiiit oilgOltr***Vilti„ttie.-44,ti r,_, g-fii';(i.VilitliM
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveya i.
0 ....,,
Juli A.Ellsworth JUL
Address(number and street) , Address(number and street) 2 n
116 Shady Lane .7 4025
City,state,and ZIP Code City,state,and ZIP k,et.c.,,,,,e.e
Owensville,IN 47665 . G/tisQN CnAt ,bi
Country Country ....ti
US US -...utp,•Kl."
01iTAINIROOKORMTOC:idititTfiViiitiitme,thatagOii',IX-i. ?'4ri.Z
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary 0 0 3.Homestead
:reiZio residence? 0 0 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 ID 5.Wind Power Device
for this residence?If yes,provide address: 0 0 6.Hydroelectric Power Device
Address(numbg and treet) _ 0 0 7.Geothermal Energy Heating or Cooling Device
r, . ,
.,- City,6s te,ZIP cod- -nd county
fliut IV q 1%5 AS-a-CS-4 o - Q-11 - „„ 11.7,,,,.4749:az 7,
vad-r,.0 altiewpg,a00/4:hreblz coftifyoMa,V ntSito.,s:DIslogigai4to,t1htbiesofrylitrigyi4,F,5199#14;:fiRligi*Omp;t:**1;4_17.itrtrm9 ;
11,..:seikiittesiaboiclopottvaorson,006,0th:1,91i1f1v.§..*ApOLkinehogirtrfiVngliagnAil, tMkoriallyitaI0Ifindlivial#0.-k,,`,:-.7::',`,
/-al\ .•&!fait.1.-,Yelruel_:.,..ii#90,0;ki:O.:0!Til..0,.0..r.;t4IP!tri,„EittiVilf9t#,MINVIII,TRA*0)!Orciki,4A0014.1.14,t$0:I!t Orfi'g#!**O*C*i**:*qW.'Fi
*
of 5 ''ZrZil>
i'... .