Homestead_Bock . - •
H. PREPARER
Prepartf,the Sales Diseklure Form 1/...-- Title
arta- hu,r
_ . p-4... Settlement Agent
Company
Address(number and street,city,state,country,and ZIP Code)
25 NW Riverside Drive,Suite 310,Evansville,IN 47708
I.SELLER(S)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on co ocument
Katye E.Adler
Address(number and street) Address(number and street)
5494 E 1300 S "t?)
City,State,and ZIP Code City,State,and ZIP Code 406 2 1 2025.
Elberfeld,IN 47613
Country Country ,
US G/6"9011/-
5,A person who knowingly and intentionally falsifies th alue of transferred
real property,or mits or falsifies any Information required to be provided,commits a Level 5 felony,
Sig turn ./ •
er , .... ( , Signature of Seller
Prinleftlam of Seller Date Si e (mm/ yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Katye E.Adler 8/Ligs
J. BUYER(S)IGRANTEE(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
Lindsey Bock
AddressIn 1umber and street) Address(number and street)
bLiefil E .
City,State,and ZIPCode I City,State,and ZIP Code
El be -t-elot A 406(5
Country Country
US
apply for certain deductions.Identify all of thosethat apply:
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YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary ( 0 3, Homestead
: CI residence? 0 0 4.Solar Energy Heating or Cooling System
, jf 2.Does the buyer have a homestead to be vacated 0 0 5.Wind Power Device
u
for this residence?If yes,provide address: 0 0 6.Hydroelectric Power Device i
Address(number and street) 0 Cii) 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County
2C- 2-3 - 1S-1-loo - 001,o LIR--02-14
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