Homestead_Edmondson 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
Joshua Edwin Mason
Addr s�_s(number nf)street) S I R SO Address(number and street)
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City,st ,a d ZIP1 Cod��p��l -t- ,� City,state,and ZIP Code
U��L�G1 p - Cr-�`/ ..i-t/" / 4 1��vCi Country
Country /
US
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
r=al property,or omits or Isifies any information required to be provided,commits a Level 5 felony.
S 2naturee • -ler Signature of Seller
- -d f Z'z -, �/l//7
l e t-, ame of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
/ - ua Edwin Mason 11/18/2022
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDEN I A L THAT APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears o v an do e nt
Christopher K. Edmondson ID Address(number and street) Address(number and street)
1105 South Eighth Street NQ(/
City,state,and ZIP Code City,state,and ZIP Co.- ?+ .1 2022
Boonville, IN 47601 _
US Country US Country ^,RSCM Co,, -
apply for certain deductions.Identify all of those that apply:
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary O O 3. Homestead
Cl O r idence? 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 O 6. Hydroelectric Power Device
Address(number and street) 0 O 7. Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
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