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Homestead_Adamson H. PREPARER Preparer of the Sales Disclosure Form Title Gina Gruse Closing Agent Company Address (number and street. city. stale, country, and ZIP Code) 6402 Railroad Avenue, Crestwood, KY 40014 USA z I. SELLERS)/GRANTOR(S) - Seller 1 - Name as it appears on conveyance document Seller 2 -Name as appears on cony- ,anc; ••• tent Cartus Financial Corporation Address (number and street) Address (number and street) , 100 Reserve Road Oe City, State, and ZIP Code t City, State, and ZIP Code Danbury, CT 06810 ?Oa • Country Country GDSO USA QV Col best of my knowledge and belief, is true, correcf,Ql i complete as 6 j required by w, and is prepared in ccordance with IC 6-1.1-5.5. A person who knowingly and intentionally falsifies the value of transferred real prop y, or omits or falsifies iy information required to be provided, commits a Level 5 felony. Signatur of eller Signature of Seller [-• • Print Name of Seller Date S igne mm/ yyy) Printed Name of Seller .Date Signed (mm/dd/yyyy) Cartus Financial Corporat on J_a- `, J. BUYER(S)/GRANTEE(S) — APPLICATION FOR PROPERTY TAX DEDUCTIONS — IDENTIFY ALL THAT-�115 M`• �' 100 Buyer 1 - Name a it ppears on conveyance document Buy,.2 - me as it ap ea s on conveyance document fy.- LvnO a y--, _ e nLo As (n era beet) Address tb andrib, r. 6 \ -e r i)r . ,) • __ Ci S to d IP od .f.)_ 14\1 Cit � t a d Z CodeY V1i tl/ y, Code y yi7._&___.) CCunlry US Country tog Fr YES NO CONDITION YES NO CONDITION © 1. Will this property be the buyer's pi imary O 0 3. Homestead residence? O © 4. Solar Energy Heating or Cooling System 2. Does the buyer have a homestead to be vacated 1 0 U 5. Wind Power Device 0 0 for this residence? If yes, provide address: ' I !] O 6. Hydroelectric Power Device Address (number and street) ! fl 0 7. Geothermal Energy Heating or Cooling Device City. State, and ZIP Code County 26 18 -3c--liO4 -000. DI- 3 -occ 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 Page 3