Homestead_Mason (27) H. PREPARER
Preparer of the Sales Disclosure Form Title
Jamie E. Oberg Escrow Officer
Company
Address(number and street,city,state, country, and ZIP Code)
101 Plaza East Boulevard, Suite 102, Evansville, IN 47715 FIL
I. SELLER(S)/GRANTOR(S)1-Name as it a ears on conveyance document Seller 2-Name as appears on conveyance docume
SellerJJJ
PP
GREGORY E. MASON PENNY G. MASON nr�y
Address(number and street) Address(number and street) `Cr J l 122 -
1123 E Ohio Street 1123 E Ohio Street
City,state,and ZIP Code
City,state,and ZIP Code GIBSOs —
NTY• C
Princeton, IN 47670-8702 Princeton, IN 47670-8702 ►v COU qU,r - '
Country Country
the best of my knowledge and belief,is true,correct and complete as
require• •y law, :nd is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred
real pro••rty,o•omits or falsifies an "nformation quired to be provided,commits a Level 5 felony.
Signaturerb--Iler Signat Seller
�fi_ J Date signed(mm/dd/
'fin -• • -• - of S re a signed (mm/dd/yyyy) Printed Name of Seller 1 9 may)
GREGORY E. 0 • October 17, 2022 PENNY G.MASON October 17, 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
ERRIN NICHOLE MASON JONATHAN E. MASON
Address(number and street) Address(number and street)
1123 E Ohio Street 1123 E Ohio Street
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670-8702 Princeton, IN 47670-8702
Country Country
YES NO CONDITIONii< YES/ NO CONDITION
1.Will this property be the buyer's primary
❑ �--,/
N1( 3. Homestead
residence? ❑ Lb 4.Solar Energy Heating or Cooling System
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2. Does the buyer have a homestead to be vacated ❑ram
E: 2.
this residence? If yes,provide address: 5.Wind Power Device
u 6. Hydroelectric Power Device
Address(number and street) 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county Ai-12-\9'- [Qy- (_)d2. 3 O --f Q z-
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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