Homestead_Gonzalez H. PREPARER
Preparer of the Sales Disclosure Form Title
Jamie E. Smith Escrow Officer
Company
Address(number and street,city,state,country,and ZIP Code)
101 Plaza East Boulevard, Suite 102, Evansville, IN 47715
I. SELLER(S)/GRANTER(S)
Seller 1—Name as It appears on conveyance document Seller 2—Name as appears on convey ment
SUSAN L. HARDIMAN
Address(number and street) Address(number and street) O
530 W Blaine Avenue c' .�
City,state,and ZIP Code City,state,and ZIP Codek. .0
Princeton, IN 47670-2904 O4'"�, ���,
Country Country 'I'
E-mail address
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is true,orrr -and c teas
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.
Xign ure of Seller A C Signature of Seller
Date signed mm/dd/ Printed Name of Seller Date signed(mm/dd/yyyy)
printed Name of Seller I g ( YYYY) I December 9, 2022
SUSAN L HARDIMAN December 9, 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
ENRIQUE J. GONZALEZ
Address(number and street) Address(number and street)
530 W Blaine Avenue
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670-2904
Country
ountry
E-mail address
to 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 2(
0 3.Homestead
residence? ❑ 4.Solar Energy Heating or Cooling System
��2.Does the buyer have a homestead to be vacated El5.Wind Power Device
El11G1 Eir
for this residence? If yes,provide address: ❑ [], 6.Hydroelectric Power Device
Address(number and street) 0 D7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county X-12-l$-3 O`-0 O 1 • 6 2 1 -O 2-8'
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
transferred real property,or omits or falsifies any Information required to be provided,commits a Level 5 felony.(Note:.Both spouse's