Homestead_Besing (3) 1 H. PREPARER
( Preparer of the Sales Disclosure Form Title
i Amanda DalY_._.._-----..------__.Tw_-___ _--•----.._-_---___..__._ Settlement Agent
_ ---.____,....- -- - -----------"--------
r+ Company
1 Address(number and street.city.state.country.and ZIP Code)
17820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715
I I.SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document I Seiler 2-Name as apeye t
Secretary Of Housing And Urban Development ■■HH'' —
Address(number and street) Address(number and street)
40 Marietta St s}.�_
r City.state,and ZIP Code t City.state.and ZIP Code MAY 2 3 2022--
�Atlanta GA 30303
t ountry --- - Cournry a. t vna)
US
I ( )
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 Signature of Setler
I
Printed Name of Seller Date signed(mni/dd/yyyy) I Printed Name of Seller 1 Date signed(mm/dd/yyyy)
, Hud _ 0J13/2022 I — , 05/04/2022
J. BUYER(S)(GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buyer 1-Name as it appears an conveyance document f Buyer 2-Name as it appears on conveyance document
Joshua Besing
Address(number and street) I Address(number and street)
905 E Walnut Street I
rCity.state,and ZIP Code 1 City,slate,and ZIP Code
Fort Branch,IN 47648 i
Country - --- 1 Country
US I
apply for certain deductions-Identify all of those that apply_ —_
YES NO CONDITION 1 YES_ _ NO CONDITION.
�,/ 1.Will this property be the buyer's primary { f�a�/ Q 3.Homestead
J� Q residence'? 0 1:X 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 1 0 a 5.Wind Power Device
Q for this residence?If yes,provide address: Q tk 6.Hydroelectric Power Device
[Address(number and street) — - -t 0 I$ 7.Geothermal Energy Heating or Cooling Device
r
City,state.ZIP code,and county I r l 1.\-\c, h.O 3 _p 0 1 . 3 3 0 01-
Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/IO/Other Number
Page 3 of 5 "