Homestead_Tenbarge H. PREPARER
Preparer of the Sales Disclosure Form Title
Shannon Valiant OFF\CE,.--
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
John Tenbarge FILED
Address(number and street) Address(number and street)
2508 Warrenton Rd.
City, State and ZIP Code City, State and ZIP Code MAY 0 6 2022
Haubstadt, IN 47639 ,
Country Country
United United States of America �n.t7 YY AUUDITOR
E-mail address
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.
Sjignatur _� y Signature of Seller
=of ellerC�!� t.•�
PriyFd Name of Seller
Date signed(mm/dd/yyyy) Printed Name of Seller I Date signed(mm/dd/yyyy)
4/22/2022
Jo n Tenbarge
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
Casey A.Tenbarge Kelley L.Tenbarge
Address(number and street) Address(number and street)
2500 Glenview Dr.
2500 Glenview Dr
City, State and ZIP Code City, State and ZIP Code
Evansville,
IN 47720 IN 47720
Country Country
United States of America '.
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 YES NO CONDITION
0 1. Will this property be the buyer's primary residence? n 0 3. Homestead
❑ Cp 4. Solar Energy Heating or Cooling System
0 ' 2. Does the buyer have a homestead to be vacated for ❑ 2, 5. Wind Power Device
this residence? If yes, provide address: ❑ 93. 6. Hydroelectric Power Device
Address(number and street) ❑ p 7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county OL —a a --(ACV
� � 5340 - 0�
edge
and belief,
Page 3copy