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Homestead_Pierrard H. PREPARER �r Preparer of the Sales Disclosure Form Title Claire Kincaid Bosse Title Company Address(number and street,city,state.country,and ZIP Codo) - 4799 Rosebud Lane,Newburgh,IN 47630 E. SELLER(S)/GRANTOR(S) - Setter 1-Name as it appears on Conveyance document Seller 2-Name as-appears On conveyance document Thomas Olds Amy Olds, ._ M. _ .w,.w.m.. Address(number and Street) Address Adwv dress(number andd street) 1315 S.SR 57 1315 S.SR 57 City,state,and ZiP Code City,slate,and ZIP Code Oakland City,IN 47660 Oakland City,IN 47660 ___. Country Country US US - 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. i X � ru rerol Seale /7{i± G^ 'i, ature of Seller A. y )e/ ► Printed Name of Seller Date signed(rani/ddfyyyy) Pr ntod Name of Seiler Date signed(mm/ddlyyyy) Thomas Olds 01/20/2022 Amy Olds 01/20/2022 J. BUYER(S)/GRANTEE(S)--APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY Buyer i -Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document Robert Plerrard Sheila June Ad reins ber and cet) Address number and slreet�, fly, late and ZIP CodQ cep state.a�P od0 - //t / /r7( / /y tic. city. Ia�titd GlfZ�l /J1( 434,0,o ,Z,., �fv Lf (v(fr(J Country O country US 0 US ' YES NO CONDITION YES, NO CONDITION cz ��,�rr i.Will this property be the buyer's primary 0 3.htomestead © Y ❑ residence? Cl t1 l 4.Solar Energy Heating or Cooling System i M 2.Does the buyer have a homestead to be vacated 0 ® S,Wind Power Device rg YIC ❑ for this residence?if yes,provide address: -�` 0 (XI 6,Hydroelectric Power Device a c..„, Urdresss(rwm er, nd reyi��' 0 ® 7.Geothermal Energy Heating or Cooling Device LA 0 - Gity, late,and ZIP Code County40 b my1 3 j -300 O�J I.35 G — 0 06 Under penalties s of perjury,urj I hereby certify that�7 this Sates Disclosure.to the best of -. -o i �a�lcn�v-'TM ^'-`�'r-�--1� �� �"'"" knowledge and belief,is true,correct and complete ..v a'`< 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 - Page 3 Oei-- C 0 PY OR