Homestead_Hamilton H. PREPARER
Preparer of the Sales Disclosure Form Title
Sherri Hudson Settlement Agent
Company
Bosse Title Company
Address(number and street.city.state.country.and ZIP Code)
4799 Rosebud Lane, Newburgh, IN 47630
I.SELLER(S)/GRANTOR(S)
Seller I-Name as it appears on conveyance document Seller 2-Name as appears n
Gibson County Holdings,LLC A ! `1_,,,i .-
Address(number and street) Address(number and street) -
-. �x L/`-1 ! AN ;) 2p22
City hstate.and ZIP Code City,state.and ZIP Code
t- i n C e-i--o i-. J--ri L-f-7 7 O y 4Q.�J
, ,,
Country Country `/-r).r,,n.r c NTY AUOtTQP
US GIBSON Cue
E-mail address
,, ( )
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 S.S.A person who knowingly and Intentionally falsifies the value of transferred
real ,or omits or any infonation required to be provided.commits a Level 5 felony.
Sigma Seller Signature of Seller
Na 1 f Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/ddtyyyy)
' `I , mber� 06/27/2022 06/27/2022
J. BUYER(S)/GRANTEE(S)-APPUCATION 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
John Hamilton Brandy Fields
Address(number�nd ) Address(number and street)
a.,OD s6tTj '- sM Q 2 ccc'? t CYl S�.
Gty �att� and c ACo�de/ ��- 117 6 q O Cstate.\and ZIP Code = L \ls2LV
Country Country
US US
E-mail address
apply for certain deductions.Identify ail of those that apply:
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary CD 3.Homestead
® CI residence? 0 ® 4.Solar Energy Heating or Cooling System
lin 2.Does the buyer have a homestead to be vacated 0 ® 5.Wind Power Device
0 for this residence?If yes,provide address: 0 Q 6.Hydroelectric Power Device
Address(number and street) 0 (21 7_Geothermal Energy Heating or Cooling Device
City,state.ZIP code.and county ,,\ Q) - 1 '�'It 0'1 -00 0 . '2-4-
O 2(
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief.Is true,correct and complete
aIn accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsities the value of
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