Homestead_Kramer (4) H. PREPARER
Preparer of the Sales Disclosure Form ! -I- _______
ite
Matthew Jarvis Escrow Officer
Company
Address (number and street, city, ste, col...Jr:L , alld ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 - Name as it appears on conveyance document Seller 2- Name as it
Gerald W. Crow,Jr. E appears on conveyance document
Julie D. Crow
Address (number and street) :Address (number and street)
541 Town Madison Blvd 541 Town Madison Blvd
City, State and ZIP Code City, State and ZIP Cade
Madison, AL 35758 Madison, AL 35758
Country ; Country
United States of America se i United States of America
Email Address
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.
5gnatu�', of�►1e1:{e�.r" 1 ,ir ,.ter - .g
Print ame of Seller -�,K: -r • . . Q iAr Oi C AO-4-'3
Date."Slgt i; mmiddi • Pnnted Nam- of :eller Date Slgnt'c3:_(mmlddlyyyy)
Gerald W. Crow, Jr. yyry) "
Julie D. Cro "
O L /0137. 0:-2(.p I D 1 losjatac,
J. BUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS -IDENTIFY ALL THAT APPLY
Buyer 1 - Name as it appears on conveyance document ii Buyer 2 - Name as it appears on
Joshua A. Kramer ii Y o nt
Address (number and street) S Address (number and street)
780 W CR 1000 S
City, State and ZIP Code City, State and ZIP Code MN 1
Haubstadt, IN 47639 , Z(?6
Country 1 Country "1
United Stares of America G/QS �
for certain deductions. Identify all of those that apply:
YES NO CONDITION 1 YES NO CONDITION
V -Mr 1. Wriii this property be the buyer's primary residence? V 3.
Heilmestead
0 V 2. Does the buyer have a homestead to be vacated for L 4_ &liar Energy Heating or Cooling System
this residence? If yes, provide address: 0 __ 5. Wind Power Device ;
Address (number and street) ❑ .. 6. Hydroelectric Power Device
® i_ 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County6 - ^/ //^
Sao oo -3s4i uo
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 transferred real
property, or omits or falsifies any information required to be provided, commits a Level 5 felony. (Note: Both spouse's information, SSN/Driver's
\ t `•a \ -4-nis�a 4 Q e ok 4 >� Page 3 Cit- - )S LT - .