Homestead_Runyon H. PREPARER 1
Preparer of the Sales Disclosure Form Title
Kelly Norton i Escrow Officer
Company
Address(number and street,city,state, country,and ZIP Code)
101 Plaza East Boulevard, Suite 102, 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
RANDALL W. JOHNSON KAREN JOHNSON
Address(number and street) Address(number and street)
7950 S Andee Lane 7950 S Andee Lane
City,state,and ZIP Code City,state,and ZIP Code
Fort Branch, IN 47648-1545 Fort Branch, IN 47648-1545
Country Country
E-mail address
Under penalties of perjury,I hereby certify this Sales Disclosure,to t e 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 elony.
Sa re of Seller Signatureeller
rinted Name of r Date signed(mm/dd/yyyy) Prin ed me of Seller Date signed(mm/dd/yyyy)
RANDALL W JOHNSON April 25, 2022 KAREN JOHNSON April 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
DARLENE RUNYON F-I-LED
Address(number and street) Address(number and street)
7950 S Andee Lane
City,state,and ZIP Code City,state,and ZIP Code MAY 0 5 2022
Fort Branch, IN 47648-1545
Country -- Country � C4i. 1/iiavi�'_
GIBSON COUNTY AtJflITOFc i
apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
d ❑ 1.Will thisresidence?property be the buyer's primary Q 3. Homestead
❑ 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated ❑ l/ 5.Wind Power Device
❑ for this residence? If yes, provide address: ❑ d 6.Hydroelectric Power Device
Address(number and street) D 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
6-Iqi- l°1 - (03- )o - .ou - O2H
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
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