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Homestead_Hoefling (3) H. PREPARER Preparer of the Sales Disclosure Form Title Shannon Valiant Company Address(number and street,city, state,country, and 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 appears on conveyance document Merle R.Wells,Jr.Testamentary Trust Address(number and street) Address(number and street) 7963 S 40 E, Fort Branch, IN 47648 City, State and ZIP Code City, State and ZIP Code Fort Branch, IN 47648 Country Country United States of America E-mail address Telephone number E-mail address Telephone number Under penalties of perjury, I hereby certify 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. Signature of Seller Signature of Seller Printed Name of Seller Date signed (mm/dd/yyyy) Printed Name of Seller Date signed (mm/dd/yyyy) Laura E. Elkins,Trustee 2/12/2021 2/12/2021 J. BUYER(S)/GRANTEE(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 o ancc�ner� Alex Hoefling Allison Hoefling L1J Address(number and street) ; Address(number and street) 436 E 795 S 436 E 795 S FFB 19 2021 City, State and ZIP Code City, State and ZIP Code Fort Branch, IN 47648 Fort Branch, IN 47648 Country Country e a, ''n) United States of America United States of America GIBSON COUNTY AUDITOR E-mail address ( Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions. Identify all of those that apply: YES NO CONDITION YES NO CONDITION 9 0 O Will this property be the buyer's primary residence? Ig."/.. ❑ 3. Homestead 0 Er 4! Solar Energy Heating or Cooling System g 0 Q Does the buyer have a homestead to be vacated for this residence? If yes, provide address: ❑ 5( Wind Power Device 0 D 6. Hydroelectric Power Device Address(number and street) 0 Er 7. Geothermal Energy Heating or Cooling Device �-l3lP G. 'MS S . City, State,and ZIP Code County 6 YzT 6 ek ,1>J -1bu-I9i Cad ssor`1 AR-19 -7-0(-1 -0Ct .333 - 026 - 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 Page 3