Homestead_Howell H. PREPARER
Preparer of the Sales Disclosure Form Title
Micah Scott Escrow Officer
Company
Address(number and street,city,state,country,and ZIP Code)
7412 Eagle Crest Blvd. Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Jordan Mays Katherine Mays
Addr ss(n. mberandstreet) Address(n mberand street)
�j4 `� fi i cs a9� L rL o 4 -'T k._wood Lr.
City,sta,t`e,and ZIP Code f_ Q City,state,and ZIP Code l �� 'L
Country 1 Country VIA'
�I S ./t
Under penalties of eerjury,I hereby certify this Sales Disclosure,to the best of my knowle e and belief,is true,correct and complete as
required by law,a Is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred
re I property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Si natu�/Seller Sig} ur o Seller
Print Ln me of Seller Date signed(mm/dd/YYYY) Printed ame of Seller Date signed(mm/dd/YYYY)
Jon.--I Mays 9-g-.)0_143 Katherine Mays `i- "ADA,/
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
Nathan G. Howell Angela L. Howell
Address(number and street) Address(number and street)
1012 South Seminary St 1012 South Seminary St
City,state,and ZIP Code City,state,and ZIP Code
Q� Princeton IN 47670 Princeton IN 47670
N Country Country
PUS US
E-mail address
apply for certain ded ctions.Identify all of those that apply:
• YES NO CONDITION YES NO CONDITION
0 1.Will this property be the buyer's primary O 0 3. Homestead
0 O O residence? O O 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0
5.Wind Power Device
0 ❑ for this residence? If yes,provide address: 0 O 6.Hydroelectric Power Device
/� Address(number p,,d street) 0 O 7.Geothermal Energy Heating or Cooling Device
City,stalk ZIP code,and county w/ 4 41i-i(D �6 _ /�/_O( _ got( - p«,_ 3(7 _Odor
.h o -
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,Is true,correct and complete
he value of
image 3 of 5
JUL 1 3 2022 s
GIB�OUN Y AUDITOR