Homestead_Hernandez H. PREPARER
Preparer of the Sales Disclosure Form Title
Kelly Norton iEscrow Officer
Address(number and street,city,state.country,and ZIP Code)
101 Plaza East Boulevard, Suite 102, Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document
Seller 2—Name as appears on conveyance document
STEPHANIE JOANNE GARCIA
Address(number and street) Address(number and street)
9794 W 800 S
City,state,and ZIP Code City,state,and ZIP Code
Owensville, IN 47665-8878
Country Country
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete as
ral requiredproperty,law,or omits or falsifies any information ith IC 6-1.1-5.5.A person who knowingl required to be provided,commits Lev and intentionally falsifies the value of transferred
el S felony.
Sigrintrire of Seller Signature of Seller
``�1,d Name// / /Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Printed of Seller I January 28, 2022
STEPHANIE JOANNE GARCIA January 28, 2022
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 on conveyance document
ANTONIOLUISGARCIA HERNANDEZ - FILED
Address(number and street) Address(number and street)
City,9794
state,eand ZIP Code City,otate.and ZIP Code
Owensville, IN 47665-8878 `[Q 01 202Z
Country Country rr JJ
E-mail address
certain deductions.Identify all of those that apply:
YES NO CONDITION YE(NO CONDITION
lJ O 1.Will this property be the buyer's primary
Q 3.Homestead
r idence? ❑ gr 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 5.Wind Power Device
Elfor this residence? If yes,provide address: ❑ 6.Hydroelectric Power Device
Address(number and street) 0 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county q C^17 21 24)Q _to n f, 71 1' 02- t .
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