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Homestead_Meny (16) H. PREPARER Preparer of the Sales Disclosure Form Title Abbigail Moers 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)/GRANTER(S) Seller 1 -Name as it appears on conveyance document Seller 2-Name as it appears on conveyance document Estate of Rose Ellen Unfried, deceased Address(number and street) Address(number and street) 506 S. Eighth Ave. City, State and ZIP Code City, State and ZIP Code Haubstadt, IN 47639 , Country Country United States of America 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. igna_tyre of Seller Signature of Seller j &)')/ i-ev.1 i9 , Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy) Elaine Michl, Personal Representative 5/24/2023 J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APP.,j. Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears con ' e document Eric D. Meny Johnna K. Meny Address(number and street) Address(number and fO, 101 N.West St. 101 N.West St. �� City, State and ZIP Code City, State and ZIP Code �. Oy(O ! Haubstadt, IN 47639 Haubstadt, IN 47639 O,y�J � O © Country Country /l�OJ) 0 United States of America United States of America O�4G NI 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: O YES NO CONDITION YES/ NO CONDITION o V ❑ 1. Will this property be the buyer's primary residence? 4Y ❑ 3. Homestead ❑ 2. Does the buyer have a homestead to be vacated for this ❑ 0 4. Solar Energy Heating or Cooling System O ❑ El 5. Wind Power Device residence? If yes,provide address: ❑ © 6. Hydroelectric Power Device M I 0 1 � 1`rn�,�jrJ� Address(pulnber and sheet) ❑ El 7. Geothermal Energy Heating or Cooling Device i State,ZIP code nd cou 7 iCQu�aSr. ,1(�( Lit`lb3G bi bCean aU' -CAS- -MO.-� t-oOC 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 information,SSN/Driver's License/ID/Other Number is necessary if a Homestead Deduction is being filed.) Page 3 6 4 .