Homestead_Davis (4) H. PREPARER
Prepares o' the Sales Disclosure Fo-rn 1 Title
Pam Hancock Closer
Company
Address (number and street, city, state, country, and ZIP Code)
221 NW 5th St, Evansville IN 47708
I. SELLERS)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document Seller 2 - Name as appears on co veyance document
TERRY L. WALLACE
Address (number and street Address (number and street)
IS
W WI Sq
14
City, state, and ZIP Code City, state, and ZIP Code
Linn , ` v-t i+ I - s
Country Country 4 ‘--/)
�p
E-mail address mail address WO "4'jelephone number
Under penalties of perjury, I hereby certify this Sales Disclosure, to the best of my knowledge a e, correct and complete as
required by law, and is prepared in accordance with IC 6-1.1-5.5. A person who knowingly and inten ifies the value of transferred
real property, or omits or falsifies any information required to be provided, commits a Level 5 felony. A/0 •
Sign ure of Seller Signature of Seller l0
Printed N c4ller Date signed (mm/dd/yyyy) Printed Name of Seller Date signed (mm/dd/yyyy)
TERRY L. WALLACE 9' -211- '
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
Colton N. Davis
Address (number and street) Address (number and street)
LoôsE R &
Ci state, and ZIP Code City, state, and ZIP Code
trait 6,13e0 I/ NJ t4 --WA 9
Country t Country
E-mail address
for certain deductions. Identify all of those that apply: 1
YES NO CONDITION YES NO CONDITION _, .
�/ f
O 1. Will this property be the buyer's primary 0 3. Homestead - --c-
residence? O O 4. Solar Energy Heat r oof • .•.y-, -
n �, 2. Does the buyer have a homestead to be vacated 0 O 5. Wind Power Device ,x
for this residence? Ifyes, provide address: �Y
0 O 6. Hydroelectric Power Device
Address (number and street) O () 7. Geothermal Energy Heating or Cooling Device
City, state, ZIP code, and county 9 ( - 1 S -) )3'`i 03 - 000,
2 _ O O C-
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