Homestead_Keach 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
Jennifer M. Jenkins
Address (number and street) Address (number and street) FILED
334 S. Seminary St.
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670 JUL 2 7 2022 Country Country (.-?.) ,
United States of America ���-
E-mail address
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.
Aig of Seller - Signature of Seller
o, Se I�Y�
Printed me of l - Date signed (mm/dd/yyyy) Printed Name of Seller I Date signed (mm/dd/yyyy)
Jennifer 'I. Jenkins 7/22/2022
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 conveyance document
Richard M. Keach Lindsey D. Beavers
Address (number and street) Address (number and street)
2112 Waggoner Ave. 2112 Waggoner Ave.
City, State and ZIP Code City, State and ZIP Code
Evansville, IN 47714 Evansville, IN 47714
Country Country
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
0 ❑ 1. Will this property be the buyer's primary residence? 0 ❑ 3. Homestead
❑ 0 4. Solar Energy Heating or Cooling System
❑ 0 2. Does the buyer have a homestead to be vacated for ❑ 0 5. Wind Power Device
this residence? If yes, provide address:
❑ 0 6. Hydroelectric Power Device
Address(number and street) ❑ 0 7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county
A6-12_- 0 Li0I —0 00 .0 43- 02 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
Page 3