Homestead_Cross H. PREPARER
Preparer of the Sales Disclosure Form Title
Milton Norman Settlement Agent
Company
Address(number and street,city,state.country,and ZIP Code)
25 NW Riverside Drive,Suite 310,Evansville,IN 47708
I SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Randall Lee Cross Gayle Cross
Address(number and street) Address(number and street) �} / /� /� /�
568 S.Poplar Hills Dr. .568 B,PoplarH its-L�rs— d 0 7 . . O k�f ii-tol 4 Ad
City.State.and ZIP Code City,State.and ZIP Code �j_I,�(�y $N 47�D�p 4
Princeton,IN 47670 _Er9lCab 0- t `t°'—`
Country Country
US US
Email Address
the best of my knowledge and ballet.Is true,correct,and complete se
required by law,and is prepared in accordance votes 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 S felony.
Sig turn of Seller ,r Signature Seller
/ irk/.mot I —2.'<sr-- dicta SlpfYed(mMdd/YYYY)
PrinI dIdddd Warms of Seller Data Signed(mm/dd/yyyy) Printed Name of
Randall Lee Cross Gay%Cross 1 /—/.S'c�5-
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS— ALL T APPLY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on
Randall Lee Cross Address(number and strswet�U//�//
Address(number and street)
568 S.Poplar Hills Dr. , 202s
City,State.and ZIP Code City.Slate.and Z!f%ode
N
Princeton,IN 47870 O y
Country Country 01
US
for certain deductions.Ida 5PPIY
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary al 3.Homestead
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O residence? 0 Ill 4.Solar Energy Heating or Cooling m
2.Does the buyer have a homestead to be vacated 0 IZ 5.Wind Power Device
O ® for this residence?If yes,provide address: O (2) 6.Hydroelectric Power Device
Address(number and street) 0 ID 7.Geothermal Energy Heating or Cooling Device
City.State,end ZIP Code County vt fr\\^13 -�2 ^0 U 2 V L T
•
Under penalties of perjury.I hereby certify that this Sales Disclosure,to the best of my knowledge and belief.Is true.correct.and complete
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