Homestead_Long 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 TT
I. SELLERS)/GRANTOR(S) �e� {...1
Seller 1 -Name as it appears on conveyance document Seller 2-Name as it appears on corye ar y �rT1r tL
Joshua M. Hoefling Mallory A. Hoefling
Address(number and street) Address (number and street) -MAY 2 2022
102 S.Weber Dr. 102 S.Weber Dr.
City, State and ZIP Code City, State and ZIP Code /f�^ Up1TOR
Haubstadt, IN 47639 Haubstadt, IN 47639 GIBSON COUNTY A
Country Country
United States of America United States of America
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.
wig r of Iler gnature of ler a HOG
Printed N me of e e Date signed(mm/dd/yyyy) Printed Name of Sell t/ "te signed (mm/dd/yyyy)
Joshua M. Hoefling 5/10/2022 Mallory A. Hoefling 5/10/2022
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
Brandon Long Tina Long
Address(number and street) Address(number and street)
157 E State Road 68,Apt 201 157 E State Road 68,Apt 201
City, State and ZIP Code City, State and ZIP Code
Haubstadt, IN 47639 Haubstadt, IN 47639
Country Country
United States of America 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? 0 ❑ 3. Homestead
❑ 0 4. Solar Energy Heating or Cooling System
❑ 0 2. Does the buyer have a homestead to be vacated for ❑ 0 5. Wnd Power Device
this residence? If yes, provide address:
0 0 6. Hydroelectric Power Device
Address(number and street) 0 0 7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county 3�o — VCD �- Dep. 90
ODq
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
transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spouse's
information,SSN/Driver's License/ID/Other Number is necessary if a Homestead Deduction is being filed.)
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