Homestead_Maier (2) 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
Estate of Sharon Kay Johns
Address( umber and street) Address(number and street)
/c' Ai, 6 / 1Yef.
G" ,, fate and;,,I., Code City,state,and ZIP Code
(1'-Z.)✓ :-Ct r1 a---- _L f i/ 7Cn t/�
Country VW Country
E-mail address
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Under penalties of perjury,I hereby certi 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.
at fe�f Seller Signature of Seller
�� ( 4 c A) 'e'/,s„,.o- QE'/if-rP��_,5Ye
ted Name of Seller Date signed( /dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Sandra Hicks, Personal Representative 08/10/2022
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
TJ Wayne Maier AL
Address(number and street) Address(number and street) v
/`f7'/ So.--/G. /O5--o E,_51
CN state,and ZIP Code City,state,and ZIP Code 1 5 /
AUG "lc-?
FJ,,0,.,0-,ell (',-/jl :y it, e.l 7l0&0
Country Country
�' US
for certain deductions.Identify all of those that apply:
N YES NO CONDITION YES NO CONDITION
Va Cl 0 3. Homestead
• 1.Will this property be the buyer's primary
p O O residence? 0 O 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated
O O 5.Wind Power Device
CZ. P O for this residence? If yes,provide address: 0 l 6.Hydroelectric Power Device
0
Address(number htreet)a� �GZ t" 0 O 7.Geothermal Energy Heating or Cooling Device
1-451
City,state,ZIP code,aty OO&
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
N transferred real prope ,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spouse's
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IL - )6- 2022-