Homestead_Brewer H. PREPARER
Preparer of the Safes Disclosure Form 1 Title
Kristina Watson l Settlement Agent
Company I E-mail address
Bosse Title Company
i Address(number and street.city.stale.country,and ZIP Code)
4799 Rosebud Lane.Newburgh.IN 47630 I. SELLER(S)/GRANTOR(S) �I
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conve Lice rT
�tE•
Jack Wamsman,II Michael D.Warnsman
Address(number and street) Address(number and street) MAY 0 5 2022
�'I .,,,3a a A c)N rS" i 830 N.Main St.
City.state.and ZIP Code " i City.state,and ZIP Code a. ,1/1cd2',E'�na
eAkzad'tJ0 e1, -1iJ 16'/I�O
Country
US
Oakland City,IN 47660 GIBBON COUNTY AUDITOR
✓ Country
US
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 an Information required to be provided,commits a Level 5 felony.
Sign re of S er Si n lure of S er
ri Na e of Seller Date signed(mna/ddlyyyy) { Printed Name of Seller t signed(rrrm/ddhyyyy)
Jack Wamsman,II 04/29/2022 Michael D.Warnsman I Drat
J. BUYERS)/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
Joshua R.Brewer f
Address(number and street) I Address(number and street)
{ 438 S.Gibson St. 1
City.state.and ZIP Code City.state,and ZIP Code
{ Oakland City,IN 47660 ih
Country j Country
US
apply for certain deductions.Identify all of those that apply:
YES NO CONDITION NO CONDITION
1.Will this property be the buyer's primary 0 3.Homestead
d residence? (3 12 4.Solar Energy Heating or Cooling System
( Does the buyer have a homestead to be vacated 0 2 5.Wind Power Device
`":tE for this residence?If yes,provide address: l 0 a 6.Hydroelectric Power Device
Address(number and street) q 0 12 7.Geothermal Energy Heating or Cooling Device
( -/
City,state.ZIP code,and count' 1 L(_ 1?-`0 2 _ 0 0 ' . 1 / 2_ _O O T