Homestead_Capehart (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Matthew Jarvis Escrow Officer
Company
Address (number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as it appears on c ey n
Justin M. Hyneman Abby I. Hyneman APR 11 2022
Address(number and street) Address (number and street)
319 E. State St. 319 E. State St. !.�
City, State and ZIP Code Princeton, INand
ZIP Code /�sO" dUNTY A oR
Princeton, IN 47670
Country Country
United States of America United States of America
E-mail address
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.
Oure j Seller Syatu e er '
P ' to Name of Seller Date signed(mm/dd/yyyy) PrintedJ/ ame o Se Date signed (mm/dd/yyyy)
}ustin M. Hyneman 4/1/2022 Abby I. Hyneman 4/1/2022
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY
to apply for certain deductions. Identify all of t that apply:
YES NO CONDITION YES NO CONDITION
0 ❑ 1. Will this property be the buyer's primary residence? 0 ❑ 3. Homestead
❑ 0 4. Solar Energy Heating or Cooling Sys 400
0 0 2. Does the buyer have a homestead to be vacated for 0 0 5. Wind Power Device
this residence? If yes, provide address: lici.
0 0 6. Hydroelectric Power Device
Address(number and street) 0 0 7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county
06- 1.)- Off- 2O3-coo.370 -oa8
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