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Homestead_Martin (11) 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 Matthew Q. Gray Michele N. Gray Address (number and street) Address (number and street) 6736 W. 400 S. 6736 W. 400 S. City, State and ZIP Code City, State and ZIP Code Fort Branch, IN 47648 Fort Branch, IN 47648 Country Country United States of America United States of America ' E-mail address ` my knowledge and belief, is true correct and complete as required by la and is,prepared in accordance with IC 6-1.1 5.5.A person who knowingly and intentionally falsifies the value of transferred real pro rty r om' for falsifie ny information required to be provided, commits a Level 5 felony. vSigign ur v Vr o Sellerq /P nt Seller Date signed (mm/dd/yyyy) Printed Name o Seller Date signed (mm/dd/yyyy) Matthew Q. Gray 5/12/2023 Michele N. Gray 5/12/2023 J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT PLY Buyer 1 —Name as it appears on conveyance document Buyer 2— Name as it appears on co a ocurnent Austin Martin Address (number and street) Address (number and street) `tljt 6771 S. 550 E. City, State and ZIP Code City, State and ZIP Code 2� Fort Branch, IN 47648 /f�s+0 2O?J7 Country Country O' United States of America No Q O�jM..J� E-mail address apply for certain deductions. Identify all of those that apply: YES NO CONDITION . YES NO CONDITION El 0 1. Will this property be the buyer's primary residence? El 0 3. Homestead ❑ © 4. Solar Energy Heating or Cooling System 0 0 2. Does the buyer have a homestead to be vacated for 0 © 5. Wind Power Device this residence? If yes, provide address: ❑ © 6. Hydroelectric Power Device Address (number and street) 0 © 7. Geothermal Energy Heating or Cooling Device City, State,ZIP code, and county p -1.0 _3 `© ( - OvQ - 5a g - 02k Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and complete 3 1. ' ,