Homestead_Buchanan H. PREPARER
Preparer of the Sales Disclosure Form Title
Escrow Officer
Matthew Jarvis
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
Adam J. Jines Megan L. Jines
Address(number and street) Address (number and street)
2225 W 400 S 2225 W 400 S
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670 Princeton, IN 47670
Country
ountry
United States of America United States of America
E-mail address
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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.
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Prin -d NO-VW'r I Date signed (mm/dd/ Printed Name of Sel r I Date signed(mm/dd/yyyy)
Adam J. Jines
5/27/2022 Megan L. Jines 5/27/2022
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
Anthony Bryce Buchanan
Address (number and street) Address(number and street) 0
201 Olive Dr
City, State and ZIP Code
City, State and ZIP Code O e--.
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Princeton, IN 47670
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Country
Country g� �
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United States of America I Tel rrber
E-mail address v N
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Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions. Identify all of se that ap
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YES NO CONDITION YES NO CONDITION
0 ❑ 1. Will this property be the buyer's primary residence? 00 0 4. Solar Energy Heating or Cooling System
0 El 2. Does the buyer have a homestead to be vacated for 0 El 5. Wind Power Device
this residence? If yes, provide address: 0 El 6. Hydroelectric Power Device
Address(number and street) 0 0 7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county
-1/-3 - 3ocD_ cots ll -cD.D7
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
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