Homestead_Hart (5) H. PREPARER
Preparer of the Sales Disclosure Form Title
Matthew Jarvis Escrow Officer
Company
Address(number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as it appears on conveyance document
Daniel Sisk, Jr. Emily Sisk
Address (number and street) Address (number and street)
705 S Hall Street 705 S. Hall St.
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670 Princeton, IN 47670
Country Country
United States of America United States of America
E-mail address
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.
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Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name o eller Date signed (mm/dd/yyyy)
Daniel Sisk, Jr. 7/8/2022 Emily Sisk 17/8/2022
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL APPLY
Buyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appear A
o e nce document
Anthonydes T Hart ,�
Address (number and street) Address (number and street) � ~
610 N. Main St. UZ J
City, State and ZIP Code City, State and ZIP C(acl �102�Grayville, IL 62844 t/
Country Country So~cOvN q�
United States of America Of
E-mail address
to apply for certain deductions. Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
p ❑ 1. Will this property be the buyer's primary residence? 0 0 3. Homestead
0 El 4. Solar Energy Heating or Cooling System
0 El 2. Does the buyer have a homestead to be vacated for ❑ Q 5. Wind Power Device
this residence? If yes, provide address: ❑ El 6. Hydroelectric Power Device
Address (number and street) ❑ El 7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county /� 00 S - �,
�G - i1a-O-7 -303 - 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
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. (Note:Both spouse's
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