Homestead_Scott H. PREPARER Preparer of the Sales Disclosure Form Title Gw-yn Shaw Escrow Officer Company Address(number and street,city,state,country,and ZIP Code) 5231 Oak Grove Road,Suite A,Evansville,IN 47715 I. SELLER(S)/GRANTOR(S) _____FilEcl) Seller 1-Name as It appears on conveyance document Seller 2-Name as appears on conveyance docume Philip R.Smith Brittney R.Smith JUL. Address(number and street) Address(number and street) )/ 2022 17462 lrishtown Road. 17462 Irishtown Road. f�]Lcc City,state.and ZIP Code Cfty,state,and ZIP Code GigSO �, ai�� Emmitsburg,MD 21727 Emmitsburg,MD 21727 COUNTY AUDITOR Country Country United States of America United States of America 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. Signatu lt6r _- Sign[a�ture of eller ce 3 -- - - Printed Name of Se Date slg (m`Jddlyyyy) Printed Na Seller Date signed(mm/dd/yyyy) Philip R.Smith OTtI (Z"ZZ- Brittney R.Smith e7 7/40 I 20Z2 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 appears on conveyance document Kristopher Eric Scott Alicia C.Scott Address(number and street) Address(number and street) 9603 W 575 S 9603 W 575 S City.state.and ZIP Code --- _ - City,state,and ZIP Code Owensville,IN 47665 Owensville,IN 47665 Country Country United States of America United States of America YES NO CONDITION YES NO CONDITION XD 1.Will this property be the buyer's primary residence? ❑ 3. Homestead 0 El 4. Solar Energy Heating or Cooling System ❑ Q 2.Does the buyer have a homestead to be vacated for ❑ © 5.Wind Power Device this residence?If yes,provide address: ❑ 0 6.Hydroelectric Power Device - Address(number and street) ❑ ® 7.Geothermal Energy Heating or Cooling Device City,state.and ZIP Code County Q6-\ --cot-Zov-cuo(-I . gLS - w