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Homestead_Elpers
H. PREPARER Proparer of the Safes Disclosure Fomi I Title -/ �' r � _7(J7 v ee /ram • Company Address(number and street,city,state,country,and ZIP Code) 7820 Eagle Crest Blvd,Suite 201,Evansville, IN 47715 I. SELLER(S)IGRANTOR(S) w -_" r_ .. .. Seller 1-Name as It appears on conveyance document Seller 2-Name as appears on conveyance document Jonathan R.Sprinkle - " i Address(number and street) Address(number and street) 900 E Locust Street City,state,and ZIP Code City,state,and ZIP Coda Fort Branch,IN 47648 Country Country lk US e 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. Si lure of Se11e Signature of Seller Hied Name of er Date signed(mm/ddlyyyy) Printed Name of Salter Date signed(mmfddlyyyy) Jonathan R.Sprinkle 01/06/2022 01/06/2022 J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY Buyer 1 Name as it appears on conveyance documentm Buyer 2-Name as it appears on conveyance document Logan Elpers Erica Fuhs Address(number and street) Address(number and street) 10051S250W 100515250W City,state,and ZIP Code City,stale,and ZIP Code Fort Branch,IN 47648 Fort Branch,IN 47648 Country Country US US ( _ 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 NO CONDITION m 0 3.Homestead o 0 1,Will this_property be the buyer's primary z a) til residence? 0 4.Solar Energy Heating or Cooling Sy o o H 2.Does the buyer have a homestead to be vacated 0 5.Wind Power Device z N r © for this residence?If yes, provide address: 0 6,Hydroelectric Power Device -< iv lel cD 7. Geothermal Energy Heating or Cool ce Address(number and street) 0 --r County xiCity,state,and ZIP Code 26-19-18-304-000.690-026 n co