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Homestead_Corwin
H. PREPARER Preparer of the Sales Disclosure Form Title Gwyn Shaw Escrow Officer 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 ! Seller 2-Name as appears on conve yance document Keith E.Doemer,Jr. Megan J.Doemer Address(number and street) t 1 {�`�""1 ( `1 �`, 0 ' -t (7 {?_SIG, Add-'s (number and street y.. -'-i' City,state,and ZIP Code F d :tty,$at''e,and ZIP Code Country ..- Country United States of America United States of America E-mail address E-mail address ' 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 ------ SlgnaFm a of Seller t r Printed Name of Sella( ` Date signed(mm/dd/yyyy) Printed Name of Seller i1 Date�s�igned mm/dd/yyyy) Keith E.Doemer,Jr. .-/-;f jv9,c`r'Z. Megan J.Doemer ,J)`"1 2 02- •• _ J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY Buyer 1-Name as it appears on conveyance document f Buyer 2-Name as appears on conveyance document Asa Corwin Address(number and street) Address(number and street) FILET) 226 South St City,state,and ZIP Code City,state,and ZIP Code rc Oakland City,IN 47660 1y F_ER 0 9 2022 Country P Country United States of America United States of America �y 1u� E-mail address GIBSON CI Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of tholl se that apply: YES NO CONDITION YES NO CONDITION El 0 3. Homestead El 1.Will this property be the buyer's primary residence? 0 ® 4.Solar Energy Heating or Cooling System ❑ ® 2.Does the buyer have a homestead to be vacated for ❑ I I 5.Wind Power Device this residence?If yes,provide address: 0 © 6.Hydroelectric Power Device Address(number and street) 0 ® 7.Geothermal Energy Heating or Cooling Device City,state,and ZIP Code�-- County / -- ) 4 .1 `3 -`rCt(A—6 0 0 .2-4 L1 -0 0 4- , Page 3