Homestead_Rostron 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. SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
Jon T.Taylor Breana R.Taylor
Ansomber Ed street)Y�� n f� Address,( r�b�`andreet)���`^� (!\/
City, tf,and Z ,^y t , //(/ y/�r n"` (f City,sta a'_�' IP lit I r // `� 7lC0 k
Co ntry `( �/(�/) ( `� li lX o Count
US US
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.
Signature of Sel ��� 'na( off Seller __ /
inted N me of Seller Date signed(mm/dd/yyyy) Printed Name of Seller ( Date signed(mm/dd/yyyy)
Jon T. Taylor 10/21/2022 Breana R. Taylor 10/21/2022
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
James W. Rostron FILED
Address(number and street) Address(number and street)
108 Doris Avenue
City,state,and ZIP Code City,state,and ZIP Code OCT 2 4 2022 Cam`
Baltimore, MD 21225 / V�
US Country CoUSuntry elh a. YY \
E-mail address �L4L� W ny IDITOt
to apply for certain deductions.Identify all of those that apply:
YES NO CONDITION / ' - - NO CONDITION
1.Will this property be the buyer's primary O , 0 3. Homestead
O residence? 0 O 4. Solar Energy Heating or Cooling System
2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
—� O for this residence? If yes, provide address: 0 p 6. Hydroelectric Power Device
Address(number and street) 0 l 7. Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county 2Ci0_Nq_31 _ 30\_ 00o. y,•(q - ooR'
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
COPy