Homestead_Johnson (22) H. PREPARER
Preparer of the Sales Disclosure Form Title 0 P'" , �.r f
Tasha Garcia-Starks ! L)�%�
Company
Address(number and street,city,state,country,and ZIP Code)
5231 Oak Grove Road,Suite A,Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document
Sander M.Kinsall Seller 2-Name as appears on conveyance document
pActd,rges number and street)
`t"-f (A id?7 2(iJ Address(number and street)
C ,s tfl, nd Z P Code ' .-
� �L) y, J City,state,.and ZIP Code
Country �-+-� Country
United States of America United States of America
E-mail address , 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.
S' atu`e of Seller , Signature of Seller
{- IIG f � �? = 0 AIF
Printed Name of Seller Date signed(mmldd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Sander M.Kinsall to Kai-1, ki rSa1(A/4- - /mil' .,;3.c5 -1
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 appears on conveyance document
Rex M.Johnson Christina Johnson
Address(number and street) Address(number and street)
512 S.Hall Street 512 S. Hail Street
City,state,and ZIP Code City,state,and ZIP Code
Princeton,IN 47670 Princeton, IN 47670
Country Country
United States of America United States of America
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: G)
YES NO CONDITION YE$ NO CONDITION cp0n
0 3. Homestead z m laj
0 1.Will this property be the buyer's primary residence? o-
❑ `, J 4.Solar Energy Heating or Cooling Sys - H
❑ 2. Does the buyer have a homestead to be vacated for 0 ,E 5.Wind Power Device ? r r
this residence?If yes, provide address: 0 6. Hydroelectric Power Device D s
Address(number and street) 0 7.Geothermal Energy Heating or Coolia ice d
City,state,and ZIP Code County
26-12-07-303-001.625-028