Homestead_Etzkorn H. PREPARER
Preparer of the Sales Disclosure Form Title
dr Agent Jeffrey Bosse Settlement
Company E-mail ad
dress
Address(number and street.city,slate,country.and ZIP Code)
2301 N.Burkhardt Road,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
Travis C.Johnson Elizabeth G.Johnson
Address(number and street) Address(number and street)
9921 W 575 S 9921 W 575 S
City,state,and ZIP Code City.state,and ZIP Code
Owensville,IN 47665 Owensville, IN 47665
Country Country
US US
E-mail address
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.
St{yre of Seller Signature of Seljer
Printed Name of Se
lg�a Date sign (mn dd/yyyy) Print-Of-game of Seller Date signed(mmldd/yyyy)
Travis C.Johnson 09/30/2022 Elizabeth G.Johnson 09/30/2022
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 copveyance document
Steven Etzkorn Nora Etzkorn -e ��
Address(number and street) Addresss(number and street)
- 4).—
9998 W 900 S 9998 W 900 S
City,slate,and ZIP Code City,slate,and ZIP Code OCT
Owensville,IN 47665 Owensville, IN 47665 0
Country Country 4 2022
US US G/RSO ,
® O 1. Will this property be the buyer's primary alO 3. Homestead
residence? o ® 4. Solar Energy Heating or Cooling System
0 C 2.Does the buyer have a homestead to be vacated CD ® 5.Wind Power Device
for this residence? If yes,provide address: 0 ® 6.Hydroelectric Power Device
— -- —_ mm�z
Address(number and street) 0 ® 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
of 5 C®PY