Homestead_Keirsbulck H. PREPARER
Preparer of the Sales Disclosure Form Title
Kelly Norton Escrow Officer
Company
Address(number and street,city,state,country, and ZIP Code)
101 Plaza East Boulevard, Suite 102, Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
ROBERT J. WRIGHT ESTHER R. WRIGHT
Address(number and street) Address(number and street)
521 E Emerson Street 521 E Emerson Street
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670-1809 Princeton, IN 47670-1809
Country Country
E-mail address ' Telephone number E-mail address Telephone number
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.
Sign ure of Seller Signature of Seller
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Printi2iNaMe of Seller Date signed(mm/ddlyyyy) Printed Name of Seller Date signed(mmldd/yyyy)
ROBERT J.WRIGHT June 23, 2022 ESTHER R.WRIGHT June 23, 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 cooarte cum ' Y O
KATELYN MARIE VAN KEIRSBULCK 11■ ■�!O
Address(number and street) Address(number and street)
521 E Emerson Street ,Jul 0 5 2n27
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670-1809 V12.2.c a. ,1- ;:,----,
Country Country
AUDITOR
be
E-mail address
GIBBON
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
❑ ❑
,Uy(J 1.Will this property be the buyer's primary rE!1 , 3.Homestead
residence? ❑ 121 4.Solar Energy Heating or Cooling System
ivf 2. Does the buyer have a homestead to be vacated ❑ V//
5.Wind Power Device
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for this residence? If yes, provide address: ❑ 6.Hydroelectric Power Device
Address(number and street) 7.Geothermal Energy Heating or Cooling Device
City,state.ZIP code.and county
q6-12-o1-Za 4-o00 r 6 81 -0 2_- : 1,