Homestead_Holmes (2) •
H. PREPARER
Preparer of the Sales Disclosure Form Title
_
Matthew Jarvis Escrow Officer
_
Address(number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713
I. SELLER(S)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as it appears ancTdAc� n
SPM Development, Inc., an Indiana corporation doing business as 1rJ L
Ad Homes
Address(number
umber and street) Address (number and street) NOV 1 6 2022
304 E SR 68
City, State and ZIP Code City, State and ZIP Code / a
Haubstadt, IN 47639 a/�F_ f 1/(/
Country Country GIBSON COUNTY AUUITO1
United States of America Tele hone number
Under penalties of perjury,I hereby certify 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 6-1.1-6.5.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 Seller Signature of Seller
Printed Name of Seller
Date signed(mm/dd/yyyy) Printed Name of Seller —i Date signed (mm/dd/yyyy)Brooke Traylor,Authorized Signer 11/7/2022
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT APPLY
l3uyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document
Shawn A. Holmes Abigail C. Holmes
Address(number and street) Address (number and street)
142 Kojo Dr. 142 Kojo Dr.
City, State and ZIP Code City, State and ZIP Code
Beaufort, SC 29902 Beaufort, SC 29902
Country Country
United States of America United States of America
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions. Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
CO 0 1. Will this property be the buyer's primary residence? D El 4. Solar Ene gy Heating or Cooling System
0 Q 2. Does the buyer have a homestead to be vacated for 0 m 5. Wind Power Device
this residence? If yes, provide address: 0 G?I 6. Hydroelectric Power Device
Address (number and street) 0 El 7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county a6 0_ 2,-7,00 0 0(1 r —QZ\-
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,end is prepared in accordance with IC 6-1.1-5.6.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
cOPY