Homestead_Keyer H. PREPARER
Preparer of the Sales Disclosure Form I 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. SELLER(S)IGRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on nve n d c e tJ
BARBARA S. HAYES ALLEN R.AUBERRY
Address(number and street) Address(number and street) JUL 2 5 2022
1904 S Main Street 2258 East 350 South
City,state,and ZIP Code City,state,and ZIP Code a{�_ A,,f ? ,
Princeton, IN 47670-3408 Princeton, IN 47670 7 Tt 0103014 Country Country COUNTY AUDITOt�
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.
f�Si turerof Seller J / �/^ Signa noff Seller ��
t/' i fCIO1/� t5 I\,�'v_, t -aZ4 O Oc,? Z d��'!M l�'li'�../it/ Z.�-�1oL��
Printed Name of Seller \ Date signed(mm/dd/yyyy) Pnnted Name of Se le `Date signed(mm/dd/yyyy)
BARBARA S.HAYES "`JJJ June 24, 2022 ALLEN R.AUBERRY June 24, 2022
J. BUYER(S)IGRANTEE(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
WARD A. KEYER
Address(number and street) Address(number and street)
903 S Adams Street
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670-2701 -- ---------
Country Country
to apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary Q 3.Homestead
ak ❑ residence? 0 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 5.Wind Power Device
❑ for this residence? If yes, provide address: ❑ cp 6.Hydroelectric Power Device
Address(number and street) 0 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county -\2-11_WI
-
G 0li- g ,.,$32s
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
�' _.
no1/4, WI ` . c\ \\ke— Cn Page 3 of 5