Homestead_Gooch (2) i H. PREPARER
Preparer of th ales Oisclesy� orm I Title
___._..._._...._ j�� - Title Company
Company
Address(number and street.city.slate.country,and ZIP Code)
7820 Eagle Crest Blvd,Suite 261,Evansville,IN 47715
I. SELLERS)/GRANTOR(S) _
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Christopher Scott
Address(number and street) Address(number and street) r T 1.J E D
428 N Gibson Street 1�1
City,slate.and ZIP Code City.state.and ZIP Code
Princeton,IN 47670
Country Country U D.7 2422
US
GIBSON COliNT 1
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 Sell r. 4 Signature of Seller
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mmldd/yyyy)
Christopher Scott 06/21/2022 06/21/2022
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
Blaine M Gooch Jaclyn Nicole Gooch
Address(number and street) Address(number and street)
507 W.Monroe St. 507 W.Monroe St.
_City,slate.and ZIP Code City,state,and ZIP Code
Princeton,IN 47670 Princeton,IN 47670
Country Country
US US
for certain deductions_Identify all of those that apply.
`V YES NO CONDITION YES NO CONDITION
0 (XI O 1.Will this property be the buyer's primary It 0 3. Homestead
residence? 0 IM 4.Solar Energy Heating or Cooling System
r"?
.moo O 2.Does the buyer have a homestead to be vacated 0 (R 5.Wind Power Device
�' / ' for this residence? If yes.provide address_ ......
O a 6. Hydroelectric Power Device
Address{number r and street) O ® 7.Geothermal Energy Heating or Cooling Device
OM City�state.ZIP c de,and county ' un/ ^ip `�( v�_ 07- os -0Os-`Oo - Oas •
�1 Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
1-,
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