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Homestead_Beard H. PREPARER Preparer of the Sales Disclosure Form Title Christa D.Tracey Escrow Officer - Company E-mail address Telephone number Southwestern Indiana Land Title christa@swinland.com (812)425-0055 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 appear o opr veyance document Laurie Beard 1LEL) I 107 City, Addresss (number and street) Address (number and street) L E Strain St. FEQ 0 3 2023 City, State and ZIP Code City, State and ZIP Code Fort Branch, IN 47648 f Country Country United States of America E-mail address Telephone number E-mail address G/Bn/y LOONTelephone number OW 5toP- 2510(/ 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 6-1.1-5.5.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. lure of Sell Signature of Seller Cf in d Name of eP-,/, Date si ned ( m/dd/yyyy) Printed Name of Seller - Date signed (mm/dd/yyyy) Prin d Name of e Laurie J. Beard 0I a bitea.,3 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 David Beard Address (number and street) Address (number and street) 107 E. Strain St. City, State and ZIP Code City, State and ZIP Code Fort Branch, IN 47648 Country Country United States of America E-mail address Telephone number E-mail address Telephone number dbeard77@hotmail.com (812) 568-9563 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 2 ❑ 1. Will this property be the buyer's primary residence? 2 ❑ 3. Homestead ❑ 2 4. Solar Energy Heating or Cooling System ❑ 2 2. Does the buyer have a homestead to be vacated for ❑ 2 5, Wind Power Device this residence? If yes, provide address: ❑ 2 6. Hydroelectric Power Device Address (number and street) ❑ 2 7. Geothermal Energy Heating or Cooling Device City, State,ZIP code, and county N ir ')--1 - - 2_ _ ©o o C 4 2-02G 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 information, SSN/Driver' License/ID/Other Number is necessary if a Homestead Deduction is being filed.) r atur o B er 1 Signature of Buyer 2/Spouse Printed Legal Name of Buyer 1 Sign Dat9(MM/DD/YY) Printed Legal Name of Buyer 2/Spouse Sign Date(MM/DD/YY) David Beard e,1 /a 4/aaRa Last 5 Digits of Buyer 1 SSN/Driver's License/ID/Other Number Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/ID/Otr ' `1S SSN: 3 a.�-6 `. 41 tlL a 6g60 COPY Page 3