Homestead_Powers (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Matthew
Escrow Officer
Jarvis
Southwestern Indiana Land Title
Address (number and street, city, state, country, and ZIP code) FILE D
60
Jr SE Martin Luther King Boulevard, Evansville IN United States of America 47713
I. SELLERS)/GRANTOR(S) I
Seller 1 -Name as it appears on conveyance document Seller 2-Name as it appears on conveyancedocument
John M. Johnson Jillian A. Johnson 2
Address (number and street) Address (number and street)
1010 N Main Dr. 1010 N Main Dr. `f72.. .e a .)
City, State and ZIP Code City, State and ZIP Code GIBSON COUNTY AUDITOR
Oakland City, IN 47660 Oakland City, IN 47660
Country
ountry
United States of America United States of America
E-mail address
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.
gnatur Se er nature of Sel r i/�1
�v \l /
Printed me of Seller Date signed(mm/dd/yyyy) Prince Name o ellerl Date signed (mm/dd/yyyy)
John M. Johnson
8/24/2022 Jillian A. Johnson 8/24/2022
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
Terrance William Powers Tracy Lynn Powers
Address (number and street) Address (number and street)
1436 S. SR 57
City, State and ZIP Code
Oakland City, IN 47660
Country
United States of America
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 't�'
❑ 0 4. Solar Energy Heating or Cooli " S
C�or. L VA 2. Does the buyer have a homestead to be vacated for 0 0 5. Wind Power Device
1P1 this residence? If yes, provide address: 0 0 6. Hydroelectric Power Device kr-`'
A ress(number and street) ��( /D • ❑ E 7. Geothermal Energy Heating or Cooling Device
��t36 S SviSR- OI lci, n Gt- D b6
C t S$tate. ZIP code. and v� cpunty, �o,,‘1C- _ _ Ig— �a _ C7a0, 3 7 _ pp—i
Underpenalties of perjury, 1 he by certify that this Sa164 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