Homestead_Kavanagh 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 conveyance document
Robert John Kavanagh
Address(number and street) Address(number and street)
St
Clot Inge 1 J
City,State and ZIP Code City,State and ZIP Code
Pf'nt-eNr` �U, LA7G-20
Country Country
`bSor,
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 A '^ ` -- Signature of Seller
Printed Name of Seller \ Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Robert John Kavanagh 03 023/aQa202 3/25/2022
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1 -Name as it appears on conveyance document Buyer 2-Name as it appears on conveyance document
dAdd r P KamanKavan gh and_ F T L E D
Address(number and street) Address(number and street)
3820 N 225 W
City, State and ZIP Code City,State and ZIP Code
Patoka, IN 47666 , APR 1 3 2022
Country Country . �"
United States of America //(.,,,a &..14`4 ,r,>)
E-mail address
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 ES- NO CONDITION
El 0 1. Will this property be the buyer's primary residence? ( --EI 0 3. Homestead„,
0 El 4. Solar Energy Heating or Cooling System
0 El 2. Does the buyer have a homestead to be vacated for this 0 21 5. Wind Power Device
residence? If yes, provide address: 0 p 6. Hydroelectric Power Device
Address(number and street) 0 El 7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county a6' _0 q-,Z j - 3 o a . o 4. 3. /.3 7 - O / 8