Homestead_Schlottman (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Abbigail Moers Escrow Officer
Company
Address(number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as it appears on conveyance document
Jacob Koberstein
Address(number and street) Address (number and street)
3295 E. Carithers Rd.
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670
Country Country
United States of America
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.
Signs r f elrftMie. Signature of Seller
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Jacob Koberstein 3/9/2022 3/9/2022
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 onveyance document
Tracy Lynne Schlottman 14k:e)
Address(number and street) Address (number and street)
727 East Emerson St.
City, State and ZIP Code City, State and ZIP Code MAR
Prnceton, IN 47670 ''s
Country Country G/ ZQ1Z rr .
United States of America BSON
to apply for certain deductions. Identify all of those that apply:
YES NO CONDITION YES/ NO CONDITION
V ❑ 1. Will this property be the buyer's primary residence? 60 V. Homestead
VA";
� ElSolar Energy Heating or Cooling System
0 t'/ 2. Does the buyer have a homestead to be vacated for ❑ Wind Power Device
this residence? If yes, provide address:
❑ LV 6. Hydroelectric Power Device
Address(number and street) ❑ �7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county
e2 tQ - 1 1- fc- AO3- nob. t o-a-a ,8
Under penalties of perjury, I hereby certify that 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
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