Homestead_Tapley 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
Ralph E. Clark Maudie G. Clark
Addr ss(number and street) yy� Address number and street) �(y�
,rl `,,, , 1' tno-pl.- Q'f • �, 9,c d� ) . 1 r.`�e•n..- 1-r -
City,stale)and IP Code City,state, d IP Code
K0(_ _ f/ 4`l(0) 5 f° O r_i A/ Lt`7(vIS'
Country � / � Country u� pi
E-mail address
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, omi or fa ifi ny info ation required to be provided,commits a Level 5 felony.4S nature o er Si nature of Seller
�( �� =
V
r d Name of ler Date signed(mm/dd/yyyy) ranted Name of Seller Date signed(mm/dd/yyyy)
Ralph E. Clark 04/05/2022 Maudie G. Clark 04/05/2022
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIF
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on co eya a cu t J�J■
Colin Tapley Mercedes Tapley
Address(number and street) Address(number and street) APR 0 8 2022
4019 W SPLIT RAIL LANE 4019 W SPLIT RAIL LANE
City,state,and ZIP Code City,state,and ZIP Code �p�
Princeton Indiana 47670 Princeton Indiana 47670 e//2,c%'J a. a2'4 n4)
Country Country GIBSON C:UUNTY AUDITOR
US US
E-mail address N
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 O 0 3. Homestead
0 Q residence?
O O 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
O for this residence?If yes, provide address: O O 6. Hydroelectric Power Device
Address(number and street) O O 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
act-0 S-22-ko O-OO 66 -01q- _
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
Page 3 of 5
R
co , Y