Homestead_Hillenbrand H. PREPARER
Preparer of the Sales Disclosure Form Title
Megan Boger 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
Buddy DeJarnett
Aiss(ozberspd stre Address(number and street)
Cif ate,and ZIP Coder a4"------..1
1 {��9 City,state.and ZIP Code
Country �A�//l/iCnt rtS 7 </ ! Country
US US
E-mail
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 infor ation r uired to be provided,commits a Level 5 felony.
ynatur of Seller Signature of Seller
i
Printed Name eller ate signed(mm/dd/yyyy) Printed Name of Seller .� to signed(mm/dd/yyyy)
Buddy D Jarnett 10/14/2022
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY nn�,,ALL Af PAO
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on cdf(y ?agce documen
Christopher Ryan Hillenbrand Jennifer Marie Hille nd 4 82.62
Address(number and street) Address(number ancalts
1121 Brookside Drive 1121 Brookside Drive ON eO ("0 toItAD
City,state,and ZIP Code City,state,and ZIP Code UNTy
Evansville, IN 47714 Evansville, IN 47714 A` O
Country Country
US US
YES NO CONDITION YES NO CONDITION (......,-)
CD O 1.Will this property be the buyer's primary C) O 3. Homestead
residence? 0 O 4. Solar Energy Heating or Cooling System
1 O 2.Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
for this residence?If yes,provide address: O O 6. Hydroelectric Power Device
Address(number and street) O O 7. Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
a.Lk- 19 - Ne you - OM.ASO -p0'7
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
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