Homestead_Mendenhall H. PREPARER
Preparer of the Sales Disclosure Form Title
Shannon Valiant C-S M' I -GC L-
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 co eyance document
G & N Homes Inc., an Indiana corporation jL'+1�T
Address(number and street) Address(number and street)
PO Box 126
City, State and ZIP Code City, State and ZIP Code 34-p 1
Wadesville, IN 47638 g2O21
Country Country G
/es0
United States of America
E-mail address address Ou 1/ q one nu
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is true,correct an'd 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.
Sign_ a of Seller i �[ Signature of Seller
C•14 /�� `I,^ C� Date signed(mm/dd/yyyy)
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller I 9
Brandon Nellis, President 9/8/2022
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 P. Mendenhall Kayla S. Mendenhall
Address(number and street) Address(number and street)
15520 A J Dr. 15520 A J Dr.
City, State and ZIP Code City, State and ZIP Code
Evansville, IN 47725 Evansville, IN 47725
Country Country ,
United States of America United States of America
E-mail address Telephone number
(618)562-8906
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 0 3. Homestead
❑ pl 4. Solar Energy Heating or Cooling System
1P ❑ 2. Does the buyer have a homestead to be vacated for 0 gas 5. Wind Power Device
this residence? If yes, provide address: ❑ ri. 6. Hydroelectric Power Device
Address(number and street) 0 I3;1:, 7. Geothermal Energy Heating or Cooling Device
%552a A 5 OiR-
City, State,ZIP code, and county
6101as'z‘...A- , r- t-Vinz5 NAgao LAAA- aC)- 1 - o47 - 30b -c oo ‘ k .-a,)c).-
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
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