Homestead_Coomer (30) H. PREPARER
Preparer of the Sales Disclosure Form Title
Matthew Jarvis Escrow Officer
Company
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 on conveyance document
Victor Dean Beard
Address (number and street) Address (number and street)
30 Third Ave
City, PIL
State and ZIP Code City, State and ZIP Code 4-1-71)
Princeton, IN 47670 /-4.tf
Country Country 10 202
United States of America 3
E-mail address
best of my knowledge and belief, is true,correcVadq�ljf�te as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the vale �' nsferred
real property,or omits or falsifies any information required to be provided, commits a Level 5 felony.
Sign t e of Selma �/`-Xi/�Y/ Signature of Seller
Printe Name of Seller Date signed (mm/dd/yyyy) Printed Name of Seller I Date signed (mm/dd/yyyy)
Victor Dean Beard 2/3/2023
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL TRAT APPLY
Buyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document
Kyla J. Coomer Daniel L. Wilson
Address (number and street) Address (number and street)
610 E. Walnut St. 610 E. Walnut St.
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670 Princeton, IN 47670
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
0 ❑ 1. Will this property be the buyer's primary residence? 0 ❑ 3. Homestead
❑ 0 4. Solar Energy Heating or Cooling Syste
❑ 0 2. Does the buyer have a homestead to be vacated for ❑ 0 5. Wind Power Device
this residence? If yes, provide address: ❑ 0 6. Hydroelectric Power Device
Address (number and street) 0 0 7. Geothermal Energy Heating or Cooling D
•
City, State,ZIP code, and county c7
aC-Il- 12 O l�Z
402--o41 .6 tS
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct and complete