Homestead_Gentry (2) H. PREPARER
Preparer of the Sales Disclosure Form Titre
Leah Brown Settlement Agent
_..... .., —
Company
Address(number and street.city.state, country,and ZIP Code)
7820 Eagle Crest Blvd,Suite 201,Evansville, IN 47715
I. SELLER(S)/G RANTOR(S)
Seller 1 -Name as it appears on conveyance document Seller 2-NameitsaPpear;on convey,- ,.--- ---nt---------- —
Cheryl Heironimus
Address(number and street) Address(number and street)
1215 Carol Ave
_
City,slate,and ZIP Code City.stale.and ZIP Code
. . _ 41041__i_._______
(
Princeton,IN 47670 *I Q/....,s, . ._,
Country Country ..
80A,
US
my knowledge and belief,is true,correct*d 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.
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Signature of Seller Signature of Seller .
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C-Ar2-•Lr-ge._
Printed Na e of Seller Date signed(rnmiddlyyyy) Printed Name of Seller Date signed(mrn/dcl/yyyy)
Cheryl Heironimus 04/21/2023 ' 04/21/2023
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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
Jered M.Gentry
Address(number and stree() Address(number and street)
526 S.Hall St.
0 —
City.state,and ZIP Code City,state.and ZIP Code
t_nrt Princeton,IN 47670
POI Country Country
Lnl US
_ i I
CONDITION
C. 1
0 1.Will this property be the buyer's primary lX1 0 3. Homestead
I Ct
(--4- i residence? j 0 a 4.Solar Energy Heating or Cooling System
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91 (X1 n 2. Does the buyer have a homestead to be vacated 1 0
1---I 5, Wind Power Device
for this residence? If yes, provide address: 0 a
N, 6. Hydroelectric Power Device
----I Address(number and street) 0 a 7.Geothermal Energy Heating or Cooling Device
• l 1
! 526 S Hall St.
1 City,slate.ZIP code.Princeton,IN 47670 and county Gibson g(),..\\- )3-- -000, 6_9 --0 ..
,
, 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
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