Homestead_Pohl (15) :H.•PREPARER: .
Preparer of the Sales Disclosure Form Title
Amv B.Pollard Settlement Agent
Company
Address(number and street,city,state,countZIP Code)
7820 Eagle Crest Blvd,Suite 201,Evansvill 7 5
.
1.SELLER{S)/GRANTOR{S).
Seller 1—Name as it appears on conveyance ttacument, _,. Seller 2—Name as appears on conveyance document
Megan Ann(Armstrong)Seifert0 Corey Allen Seifert
Address(number and street) 202 Address(number and street)
1141 W 800 S {��� •� 1141 W 800 S
City,State,and ZIP Code O/v G,O Q City,State,and ZIP Code
Fort branch,IN 47648 Uti Fort Branch, IN 47648
USCoun� -quo Uuntry
required,by•iaw,and is prepared in accordance with IC 6'1 1 5:5.A.person who knowinglyand intentionally falsifies the value of transferred;.
real'property,;o mits,o es ary information,required to.be,provided,comma a,Level,5 felony:.:.. : ,-,
Sig tu I\ Signet f el
Printed Name of Seller Date Signed(mm/dd/yyyy) Printe• a f Seller Date Signed(mm/dd/yyyy)
Megan Ann(Armstrong)Seifert 06/29/2023 Co y Allen Seifert 06/29/2023
J,; B.uYERt s /G:RANTEE s,) : APP,LICATION'v,FORPROPtRTY;TAX DEDUCTIONS IDENTIFY-ALL THAT APPLY -
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document
James I.Pohl Jamie Bruce
Address(number and street) Address(number and street)
1024E750S 1024E750S
City,State,and ZIP Code City,State,and ZIP Code
Fort Branch,IN 47648 Fort Branch,IN 47648
Country Country
Us US
YES NO CONDITION YES NO CONDITION
:,Qi, p 1.Will this property be the buyer's primary , O 3.Homestead
residence? 0 Cg 4.Solar Energy Heating or Cooling System
0 ......A.: 2.Does the buyer have a homestead to be vacated 0 t 5.Wind Power Device
for this residence?If yes,provide address: 0 M 6.Hydroelectric Power Device
Address(number and street) 0 ® 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County c+ti f .. Is _2j4_300 _0 0 0 I 13_C.Z ____
Under penalties of perjury,l_hereby certify that this Sales S;Disclosure,to the-best of my knowledge and beilef;is true;correct,and,complete
as.required:by law,and Is prepared:In accordance with IC 6-1.1-5 A person who knowingly and:Intentionally.falslfes the.value,of.
'transferred real property,.or omits orfalsifes any Informatiornrequired to be:•provided,commits'a Level 5 Stony.:{Note:Both.spouse's
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a/if ,.. fix:
3.� r "Z
® 6. Is the seller financing the sale?(If yes,
answer questions 7-8)