Homestead_Rose 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
The Estate of Joan K. Barrett(a/k/a JoAnn Barrett), deceased
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Address(number and street)
City�\J!e,a Fodel/•` C i" / / :n:te
ZIP CoCountry �(
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Under penalties o •erjury,I hereby certify this Sales isclosure,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 prope, ,or omits or falsifies an formation required to be provided,commits a Level 5 felony.
if ur App.•-Iler, Q Signature of Seller
4111
-d Nam- •f Sell r ate signed(mm/ddlyyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Lori A.Fre•-rick,Personal Representative 03/30/2022
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDE on ILfTH P to
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears v e d
/ �chael A. Rose
( Address fnumberancrif eet) Address(number and street) APR 04 2022
407 S 6TH AVE
City,state,and ZIP Code City,state,and ZIP Code /�
Haubstadt Indiana 47639 a.t'1 _i
Country Country GIBSON COUNTY AUDITOR
US
E-mail1NNaIdr�s�
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Pursue t 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 ClO 3. Homestead
O LJ residence? 0 0 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
O )J for this residence? If yes, provide address: p p 6. Hydroelectric Power Device
Address(number and street) 0 p 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county a 6, - / 7 - D U - y Sr-.3- ev d / . S/. T ',0%Li i
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