Homestead_Fouts (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 conve e doc t
Mark S.Weaver ,C� �!
,...0• Address(number and street) Address(number and street)
1 , a 3 Code � /�1/�` 5\,;/ � �Z�
Ci state,and ZIP Code � City,state,and Ztl�
V C 5Ay FL . 3z�1 o u So
Country Country ��0�
US ' P
E-mail addr s. I� ( /�
knowingly and intentionally falsifies the value of transferred
real pr.p' ,or omits or falsifies an information required to be provided,commits a Level 5 felony.
SS�ii((���nat, r:otZil Signature of Seller
PtTnt '' Na tie of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Ma 'Weaver 01/31/2023
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
Joshua A. Fouts Haylee N. Fouts
Address(number and street) Address(number and street)
3107 E Curtice Lane 3107 E Curtice Lane
City,state,and ZIP Code City,state,and ZIP Code
YES NO CONDITION S NO CONDITION
1.Will this property be the buyer's primary O O 3. Homestead
O O residence?
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: O O 6. Hydroelectric Power Device
Address(number and street) 0 O 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county
—/ — /5— /ate—c o,V. 23 '—oa-'
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
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