Homestead_Bean 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) r7 'a
Seller 1 —Name as it appears on conveyance document Seller 2—Name as it appears on co`C c e document C
Guardianship of Shirley Cowing, an incapacitated adult
4
Address (number and street) Address (number and street)
412 Roosevelt Dr. eel.
City, State and ZIP Code City, State and ZIP Code 0Prin I)
Couceton, IN 47670 Country CiaSON 20?j
y C
United States of America O`ti ephone number
E-mail address
commits a Level 5 felony.
ignatureDof Sellers �>2 / ra ltan Signature of Seller
I)a-4.-� S . ►'r' -t, L7
etu
Printed Name.of MSeller,//�/ G ,an Date9/23/2022 signed (mm/dd/yyyy) Printed Name of Seller
It
J. �
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY
signed (mm/dd/yyyy)
1 Buyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document
i Michael J Bean Paula E. Bean
IAddress (number and street) Address (number and street)
6138 Grassland Ave. 6138 Grassland Ave.
City, State and ZIP Code City, State and ZIP Code
I Portage, IN 46368 Portage, IN 46368
Country Country
United States of America United States of America
E-mail address
used to apply for certain deductions. Identify all of those that apply:
Y7NO CONDITION YES NO CONDITION
0 1. Will this property be the buyer's primary residence? 0 3. Homestead
/ ❑ Pr 4. Solar Energy Heating or Cooling System
0 �d 2. Does the buyer have a homestead to be vacated for 0 42r. 5. Wind Power Device CD
this residence? If yes, provide address: ❑ 6. Hydroelectric Power Device
Address (number and street) 0 7. Geothermal Energy Heating or Cooling Devi
City, State, ZIP code, and county
.a(4-11 — 1s-g00- oou2_ 6 )- -02+ -
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