Homestead_Green H. PREPARER
Preparer of the Sales Disclosure Form Title
Stacey Salzman Settlement Agent
Company
Address(number and street,city.state.country,and ZIP Code)
2301 N.Burkhardt Road,Evansville,IN 47715
I.SELLER(S)/GRANTOR(S) > ��r
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on r-,1�b ,!'eL�t
Mayberry Custom Millwork,LLC
Address(number and street) Address(number and street) MAR 2 9 2022
2200 N.Grand Ave.
City.state.and ZIP Code City,state.and ZIP Code �
Evansville,IN 47711 V/Lt a. `°)
Country Country GIBSON COUNTY AUDITOR
US
E-mail address
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 Signature, Seller
n� �Ul lh..�ti ` '171 b.2/ <rY lrs-i r "7'‘O lY1 '
ri led Nam ell e of Ser V Date signed(mm/dd/yyyy) ame of S�ilef Date signed(mm/dd/yyyy)
James Mayberry,Member 03/24/2022 0 f D`) M1t jle_.`r.) t eryl bc,I) 03/24/2022
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
Ashley Ann Marie Green Christian Green
Address(number and street) Address(number and street)
1126 Regency Ct. 1126 Regency Ct.
City,state.and ZIP Code City.state,and ZIP Code
Evansville,IN 47710 Evansville,IN 47710
! Country Country
US US
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions_Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
1_Will this property be the buyer's primary 0 3.Homestead
residence'? 0 al 4_Solar Energy Heating or Cooling System
' 2.Does the buyer have a homestead to be vacated O LB 5.Wind Power Device
O for this residence?If yes,provide address: 0 a 6.Hydroelectric Power Device
Address(number and street) O al 7_Geothermal Energy Heating or Cooling Device
City.state.ZIP code.and county 1.p _ I ) I 1 Q 1 -0 t00. 'Z I , Q ,-02,6,
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
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