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Homestead_Grant
:�u z ---.----- __-_____ H. PREPARER - _ a _� Preparer of the Sales Disclosure Form — Title 1 , Sherri Hudson Settlement Agent Company Email Address First Advantage Title Services, LLC _ Address (number and street, city, state, country, and ZIP Code) 2301 N. Burkhardt Road, Evansville, IN 47715 I. SELLER(S)/GRANTOR(S) 7: .'4 i...n .fu� L..y... ` -_ -' - ` Seller 1 —Name as it appears on conveyance document Seller 2 — Name as appears on conveyance document Dawn Marie Rabold Address (number and street) ` Address (num and street) 377 E 750 S . City, State, and ZIP Code City, S : and ZIP Code .pit , Fort Branch. IN 47648 Country untry US Email Address Telephone Number / email Address NoY Telep mber ( ) `: ;1 0 ( ) Under penalties of perjury, I hereby certify this Sales Disclosure, to the est of my knowle- -td'belief, is true ec#, and complete as required by law, and is prepared in accordance with IC 6-1.1-5.5.'A per-so who knowingt '- .. ntlonally falsifies the value of transferred real property, or omits or falsifies any information required to be provide°, commits a Leve , - '> :::. Signature of Seller ' Sig ature of Seller C7� � �q Printed Name of Seller Date Signed (mm/ddiyyyy) Printed Name of Seller 4. l► a .-e Signed (mmtddtyyyy) Dawn Marie Rabold 10/31/2025 101'31/2025 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 i K le D. Grant Al, son B. Grant Address (number and street) Address (number and street) 106E Oak St. 106EOakSt. City,State, and ZIP Code City, State, and ZIP Code Fort Branch, IN 47648 Fort Branch, IN 47648 Country Country ' US US YES NO CONDITION YE NO CONDITION I N. 0 1. Will this property be the buyer's primary D 3. Homestead O 1 residence? D ® 4. Solar Energy Heating or Cooling System O 2. Does the buyer have a homestead to be vacated 0 ® 5. Wind Power Device for this residence? If yes. provide address: 0 (L 6. Hydroelectric Power Device gAddress (number and street) l Q a 7. Geothermal Energy Heating or Cooling Device t 'r l it f City, State, and ZIP Code County( F 1/ /3rx�c:/ ✓A/ `.7 ,1 -I G - �° - o©. � - -o Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best 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. ('Note: Both spouse's ; Page 3 '‘....-40 it).- t • , • , . ,.....____.