Homestead_Pea H. PREPARER
Preparer of the Sales Disclosure Form Title
Stacy Brown Settlement Agent
Address(number and street.city.state.country.and ZIP Code)
2301 N.Burkhardt Road,Evansville,IN 47715
I.SELLERS)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document Jacob Page F I L FJ 13
Address(number and street) Address''\` Address(number and street)
____ 1 Li l.N t exf 1T 1 I 1!S City.state,and ZIP Code
City.state.and ZIP Code .J �L t.Q,8w 3 APR 05 2022
Mt' < �rt''�e I ,Z
Country Country US `%) _L. 'e a. 't k'rt o
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 Signature of Seller
Printed Name of S
Jler `� Date9 YYYy� signed(mm/dd/ ) Printed Name of Seller I Date signed(mmiddiyyyy)
Jacob Page
04/01/2022 1 04/01/2022
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 on conveyance document
Lisa R.Pea
Address(number and street) Address(number and street)
805 N.Main St.
City.state.and ZIP Code City.state,and ZIP Code
Princeton,IN 47670
Country
ountry
US
apply for certain deductions.Identify all of those that apply:
g# YES NO CONDITION YES NO CONDITION
ON
1.Will this property be the buyers primary g C) 3.Homestead
O residence? 0 I� 4.Solar Energy Heating or Cooling System
' 2.Does the buyer have a homestead to be vacated 0 CSI 5.Wind Power Device
0 yQ for this residence?If yes,provide address: 0 3 6.Hydroelectric Power Device
Address(number and street) 0 ® 7.Geothermal Energy Heating or Cooling Device
City.state.ZIP code.and county h C1 6--12 01 14 CAS,.002 . `.l=0 0 W
5 ,r-. ;
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