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Homestead_Ballard (4) IH. 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 Lisa A. Chaddock Address (number and street) Address (number and street) 1689 E. Lincoln Pass City, State and ZIP Code City, State and ZIP Code Haubstadt, IN 47639 Country Country United States of America E-mail address address Telephone number Under penalties of perjury, I hereby certify 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. Sjgnature of Seller^\ Signature of Seller Printed Name of Seller Date signed (mm/dd/yyyy) Printed Name of Seller I Date signed (mm/dd/yyyy) Lisa A. Chaddock 8/2/2022 J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL T AT APPLY Buyer 1 -Name as it appears on conveyance document Buyer 2-Name as it appears o ance document Roger A. Ballard Lana K. Ballard � Address (number and street) Address (number and street) 1441 N. State Road 65 1441 N. State Road 65 q/j .46.4".),_\ 6' City, State and ZIP Code City, State and ZIF�,���q�e to Princeton, IN 47670 Princeton, IN 4767Us'O4, eq., Country Country 0OGN United States of America United States of America 1'y�� E-mail address 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 p ❑ 1. Will this property be the buyer's primary residence? 0 ❑ 3. Homestead ❑ 2 4. Solar Energy Heating or Cooling System ❑ 0 2. Does the buyer have a homestead to be vacated for ❑ p 5. Wind Power Device this residence? If yes, provide address: ❑ p 6. Hydroelectric Power Device Address (number and street) ❑ 1 7. Geothermal Energy Heating or Cooling Device City, State,ZIP code, and county �y �tQ- -\\Q- 'ZC , - ©0a.L-k -C.),4 . 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