Homestead_Martinez H. PREPARER -
Preparer of the Sales Disclosure Form Title
Abbey Moore Closing Agent
Company
Address (number and street, city, state, country, and ZIP Code)
4905 Theater Drive, Evansville, IN 47715
I. SELLER(S)/GRANTOR(S) _ '
Seller 1 -Name as it appears on conveyance document Seller 2—Name as appears on co yan do merit
Karen A. Reader
Address (number and street) Address (number and street)
640 Richlyn Drive _./474/
-----4b
' City, State,and ZIP Code City, State, and ZIP Code O
Adrian, M 149221 <20
Country Country Q�e �6
USA S�
N •
— _
Under penalties of perjury, I hereby certify Ihis Sales.Disclosuro, to the best of my knowledge and belief, is t r d cornplcto as ~
required.by law, and is prepared in acco►dance,with,l,C 6�1.1.5.5.A po son who knowingly and intentionally falsifie flo ue of transferred
real.property,or Omits or falsifies any tritfomhation required to;be.provfded, commits a Level 5 felony, 7
Sig tore of alot.„61.A.1.,.,. Signature of Seller
Printed Name of Seller Date Signed (mlNdd5e3V) Printed Name of Seller Date Signed (mmkdd/yylry)
Karen A. Reader I ems."'I -a
J. BUYER(S)/GRANTEE(S) —APPLICATION FOR PROPERTYTAX DEDUCTIONS— IDENTIFY ALL THAT APPLY.
Buyer 1 -Name as it appears on conveyance document Buyer 2-- Name as it appears on conveyance document
Abdias Martinez Sharismar Martinez
Address (number end street) Address (number and street)
6587 West Pine Tree Lane 6587 West Pine Tree Lane
City. State,and ZIP Code City, State, and ZIP Code
Owensville, IN 47665 Owensville, IN 47665
Country Country
USA USA
_Pursuant to IC 61.1-12-44, the Sales Disclosure Form may be used to apply for certain deductions.-Identify all of those that apply: •
YES NO CONDITION YES NO CONDITION
❑ 1. Will this property be the buyer's primary El3. Homestead
residence? ❑ El 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated ElEl5. Wind Power Device
xf ❑ for this residence? If yes, provide address: ❑ 0 6. Hydroelectric Power Device
Address{fiber and fey ❑ 7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code.ay
(2 ' Ll ) 71 S 26- 1 o - 36--400 001 Th9- i 02\
Under penalties.of per)u , I hereby cortify that this Sales Disclosure, to the hest 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
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