Homestead_Haake (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Micah Scott Escrow Officer
Company
Address(number and street,city,state, country,and ZIP Code)
7412 Eagle Crest Blvd. 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
Christopher W. Ervin Brianne R. Ervin
Address number and street) .n Address(number an strees)
41 s fl��yy fJr- N3lS / :vile PJr
City,state,and ZIP Code / City,state,and ZIP Code
F1.1i-N—S.L,�-“P ��-,/✓ Ytir- ', `l F vA a+i kn.4f 1 -�u✓ Li i7 .f7 ` 1
Country Country
1,� 5 V c 4
E-mail address „ /4
Under penaltiesrof 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, ommits a Level 5 felony. q /�q
Si ature f Iler G Si at,y of Sep P J�/v - `/L
•
1 d a6mee off'nSSellleDr C��Date signed(mm/dd/yyyy) rinted ame of Iler Date signed(mm/dd/yyyy)
Christopher W. Ervin 03/18/2022 Brianne R. Ervin 03/18/2022
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
Debra A. Haake 'T.T E-'
Address(number and street) Address(number and street) 1 L
' 504 N 3rd St
N City,state,and ZIP Code City,state,and ZIP Code 2�22
(-) Owensville Indiana 47665 MAR 2 9
O Country Country
ttivx„a/ba,a a_ p TOR
E-mail address / /
GIBS ( )
0 Pursuant to IC 6-1 1-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those that apply:
O YES NO CONDITION YES NO CONDITION
0 1.Will this property be the buyer's primary O O 3. Homestead
l O O residence?
O O 4.Solar Energy Heating or Cooling System
p 2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
-.7" for for this residence? If yes, provide address: O C) 6. Hydroelectric Power Device
t
Address(n mber and street) 0 p 7. Geothermal Energy Heating or Cooling Device
C 0� %✓. 3r Si-
( City,state, IP code,and county �2G-/8-/3-fay_coo
C— L,yor% SI.�LU vol/ y�ic�s . ///-O 4.t Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete