Homestead_Berberich . ,
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)IGRANTOR(S) ,
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Estate of Mary E.Wray Estate of Mary E. Wray
Addreisivber a street)
City, e,an.c1 ZIP Code
Country
US V_ ..(.) /ant
did( b(-/ /6'2(406 , Address(numbefAnd 71) 1ar /arm
IM6
City,s7,72,10o2biod
Country
us Okli, iAl -2;/&.9?& 0
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 transferre
real property,or omits or falsifies any Information required to be provided,commits a Level 5 felony. .
•
-,
tn92:eof-Seller ninatnller
. ^Pe v'fro le te_ / k e/0 ed 5 c h-fec-/;--e_•,Z) re 1-56 AA verve_te_ii-k.sive
Printed Name of Seller Date signed(mm/ddlyyyy) Printed Name of Seller I Date signed'(mm/dd/yyyy)
Thomas R.Wray Personal Representative 03/22/2023 Ellen kW.Wilkinson Personal Representative 3/22/2023
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY AL .2 •PPLY
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveyan e d•iu .-nt
Julie Berberich Matthew Berberich f v/
Address(number and street) Address(number and street) 1149
.
338 South Jackson Street
City,state,and ZIP Code
Oakland City, IN 47660 338 South Jackson Street
City,state,and ZIP Code
Oakland City, IN
.
Country Country 4/
I 0
US US oejc:2.z,
____ 4ii:
YES NO CONDITION NO CONDITION Siz-5-82, g04
(0 0 3. Homestead
1.Will this property be the buyer's primary
(0 0 0 residence? 0 4. Solar Energy Heating or Cooling System
\
2.Does the buyer have a homestead to be vacated 0 0 5.Wind Power Device for this residence? If yes,provide address: 0 E 6. Hydroelectric Power Device
CD
....1-- MrA,c61 strlt)c{c/Ks N cfPruit 0 E 7.Geothermal Energy Heating or Cooling Device
1,,,.< btaskeaaode, fg 4.1(1)(,00 ,N-o_ --07_1401 - oo .321 021 .
I
I Under penalties of perjury, hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete
__D--- as required by law,and is repared 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's License/ID/Other Number is necessary if a Homestead Deduction is being filed.)
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