Homestead_Moyer (2) H. PREPARER
Preparer of the Sales Disclosure Form Title
Payge Marx 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
Daryl Jenkins
Addrw s(nu�ber and street)�^ L Address(number and street)
City, atg an IP tit -D`, t14 41 n0^ City,state,and ZIP Code
Country tr L• `� L Country
US US
( )
Under penalties of pe 1 hereby certify this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete as
required by law,an P pared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred
real property,or s f ifies any information required to be provided,commits a Level 5 felony.
Signature of r Signature of Seller
anted Name I Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Daryl Jenkins 10/31/2022
J. B TEE(S) -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFFLtrAEDBuyer 1-Name as it appears n conveyance document • ears on conveysAaron R. Moyer Danielle M. Moyer
Address(number and street) AJ m er and street) Q'/ 1
302 East Vine Street 302 East Vine Street 2022
City,state,and ZIP Code City,state,and ZIP Code
Fort Branch, IN 47648 Fort Branch, IN 47648 GIBS C2 /
Country Country ON GUVNTY q--4"
1.Will this property be the buyer's primary (` 0 3. Homestead
O 0
residence? ` L,,O/O O 4. Solar Energy Heating or Cooling System
-�2:71 xis 2. Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
O for this residence? If yes,provide address: p O 6. Hydroelectric Power Device
A znumit efeet)I` i g- C� 0 l 7. Geothermal Energy Heating or Cooling Device
Ci state,Z Code,and younty r 1
der pens ties 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
transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spouse's
information,SSN/Driver's License/ID/Other Number is necessary if a Homestead Deduction Is being filed.)
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