Homestead_Snyder III (2) H. PREPARER _ '
i Preparer of the Sales Disclosure Form Tale
Kelly Norton ,Escrow Officer _ _ _
Company
-
Address(number and street,city,state, country, and ZIP Code)
101 Plaza East Boulevard, Suite 102, Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
MICAH YOUNG -
Address(number and street) I Address(number and street)
312 E Vine St, PO Box 3
City,state,and ZIP Code City,state,and ZIP Code
Francisco, IN 47649-9774
Country Country
E-mail address Telephone number E-mail address Telephone number
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.
` ina✓eof!l?py //(. 7S P t 6: Signature of Seller
PrintedName of Seller Date signed
(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
MICAH YOUNG March 29, 2022 March 29, 2022
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1—Name as it appears on conveyance document I Buyer 2—Name as it appears Orr ce rep
e
MICHAEL L. SNYDER III a J
Address(number and street) Address(number and street)
312 E Vine St APR 0 1 2022
City,state,and ZIP Code City,state,and ZIP Code
Francisco, IN 47649-9774 �-/Leez-e a. La'aX ,- -
Country Country GIBSON COUNTY AUDITOR
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
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1.Will this property be the buyer's primary Dr. Homestead
residence? ❑ U✓ . Solar Energy Heating or Cooling System
�Does the buyer have a homestead to be vacated ❑
.Wind Power Device
❑ L J for this residence? If yes, provide address: El �.Hydroelectric Power Device
Address(number and street) ❑ 7. Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county 't I-‘11 --2 --(O` —0 0 O 00 r _x O,
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
transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spouse's
Information,SSN/Driver's License/ID/Other Number is necessary if a Homestead Deduction is being filed.)
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