Homestead_Atehortua 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 appe n conveyance document
Megan Robinson
Address (number and street) Address (number an Wit tf
624 Water I)Tower Road
City, state, and ZIP Code City, state, and ZIP Code
Owensville IN 47665Coun ,4�G
USA USA
U Country 9 CU25
to the best of my knowledge 01 1i - • -, correct and complete as
required by law, and Is prepared in accordance with IC 6-1.1-5.5. A person who knowingly and intentio IilltMer • s the value of transferred
real property, or omits or falsifies any information required to be provided, commits a Level 5 felony. •fi
Si na tp Seller - Signature of Seller
Printed Name of eller Date signed (mm/ddlyyyy) Printed Name of Seller Date signed(mmldd/yyyy)
Megan Robinson V24-PS-
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
Heriberto Valencia Atehortua
Address (number and street) Address (number and street)
701 East Water Street
City, state, and ZIP Code City, state, and ZIP Code
Princeton IN 47670
Country Country
USA USA
for certain deductions. Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
E 1. Will this property be the buyer's primary E 0 3. Homestead
residence? 0 E 4. Solar Energy Heating or Cooling System
0 . Does the buyer have a homestead to be vacated 0 E 5. Wind Power Device
for this residence? If yes, provide address: 0 0 6. Hydroelectric Power Device
Address (number and street) 0 E 7. Geothermal Energy Heating or Cooling Device
City, state, ZIP code, and county % - n l — I 1 O2 _ OQO , _o
2,8
Under penalties of erjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and complete
as required , law, -nd is prepared in accordance with IC 6-1.1-5.5. A person who knowingly and intentionally falsifies the value of
transferred '!`-
erirl.4.4 .
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