Homestead_Dewig (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Kandace Rogers Closing Agent
Company
Address(number and street,city,state,country,and ZIP Code)
4905 Theater Drive, 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
Glenn D. Hunsaker T T
Address(rmber andstreet) Address(number and street) I.L (\
EP-
City.state,ann'ddXZ_ICP_Code tl`�r�I`I�,, `— q ��/� City,state,and ZIP Code NOV O 1 2022 \ v
11:7)
VtdkQat ‘4 AU1oS ICJr1 -!1 11
Country Country ?co/ {� `
USA `'� OAler 14t1�76'Tc
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 D // ;] �- Signature of Seller
Printed Name of Seller 'a--#-.Sf/ Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Glenn D.Hunsaker October 28, 2022 October 28, 2022
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary 0 Q 3. Homestead
0 ❑ residence? 0 0 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated ❑ 0 5.Wind Power Device
❑ for this residence? If yes,provide address: 0 0 6.Hydroelectric Power Device
Address number and street) 0 El 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county �6� 12-01-t O` -OO' - 2 S k -Q 2_-S .
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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