Homestead_Scales Sr (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 conveyance document
Randall A. Scales,Jr.
Address(number and street) Address (number and street)
252 E 200 S
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670
Country Country
United States of America
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.
lure of S�ller Signature of Seller
anted Name of eller
3/30/2022
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THTAPPLY
Buyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appears on Z/ ce document
Randy
re Scs n Sr.
Address(number and street) Address (number and street)
2178 Old Hwy 41
,40
Princeton, N and
ZIP Code City, State and ZIP Cocd/ Apr 07247
�
Country United tates of America Country aCN CoUQ i
E-mail address
to apply for certain deductions. Identify all of those that apply:
YNO CONDITION YES NO CONDITION
Will this property be the buyer's primary residence? El 3. Homestead
❑ 0 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated for El 5. Wind Power Device
this residence? If yes, provide dress: CI 6. Hydroelectric Power Device
A ss(number and street) 7.4—j2'-1 cl —Li 00 0 0 7. Geothermal Energy Heating or Cooling Device
c \±--$ 5 Ol A UI.S t y4 I 0 01 • Zvi -02A-
Cit ,State,ZIP code, and V ounty
,,-yv ,r � ",n,� -�j'4-6 , �k-e -\ _k. q -a00- 00(•31(, IQ,'•?_
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
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