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Homestead_Hemmings 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. SELLERS)/GRANTOR(S) Seller 1-Name as it appears on conveyance document Seller 2-Name as appears o,4: ance document NORENA JAYNE SCHAFER Address(number and street) Address(number and street) 3367 S US Highway 41 4,67,b City,State,and ZIP Code City,State,and ZIP Code ,C'iD4 Princeton, IN 47670-9211 IT 1> ?i Country Country E-mail Address of my knowledge and belief,s tP ect and complete as required by law,and Is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifie the value of transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. Si nature of Seller C� -c98 - qQ Signature of Seller It- 'nt d Name of Selle r ate Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy) NORENA JAYNE SCHAFER March 23, 2023 March 23, 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 JOSHAUA M. HEMMINGS Address(number and street) Address(number and street) 3367 S US Highway 41 City,State,and ZIP Code City,State,and ZIP Code Princeton, IN 47670-9211 Country Country CONDITION 1.Will this property be the buyer's primary ❑ 3.Homestead ❑ residence? ❑ d 4.Solar Energy Heating or Cooling System 2.Does the buyer have a homestead to be vacated ❑ 46. S Wind Power Device ❑ for this residence? Ifyes,provide address: Hydroelectric Power Device ❑ Y Address(number and street) 0 I r.Geothermal Energy Heating or Cooling Device City,State,ZIP code,and County %-\Z- 30-3 CO - )O 1 -.s- - C 2± • 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 '`` Y