Homestead_DeNike H. PREPARER
Pepomro[the Sales Disclosure Form lnUa
Shelby Head Closing Agent
Company
Address(number and street, city,state, country,and ZIP Code)
4AO5 Theater Drive, Evansville, |N47715
|. SELLER(S)/GRANT[,R(S)
Seller 1 -Name avit appears vn conveyance document on 2 m Pncje�,j
Jonathon Shane K4inbznand K4e|iasoO. K4inton |�uvocab|eL
Address(number and street) aug (number u 0 '
12GDO Kiddie Road
. ^y
City,State,and ZIP Code Cuy,State,and ZIP Code
Lynnville, IN 47619 '
)cnuntn Country
USA '
Under penalties v,prhu,v.|hereby certify 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 oytransferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
( re v/Seller Signature orSeller
A
Pho0 ame of Seller Date Signed (nmlddyyyyy) Printed Name ofSeller Date Signed(mmNd/yyyy)
Jonathan Shane Minton,Trustee June 30, 3023 June 30' 2023
J. ESUYER(S)/KSRANTEE(G)-APPLlCAT|QW FOR PRC}PERTYTAx DEDUCTIONS-IDENTIFY ALL THAT APPLY
avyn,1-Name aoit appears un conveyance document suyoru-wameanitoppearnm!cnnvoyonoodooumom
Jeffrey Gene OaNike
Address(number and street) Address(number and street)
6851 South Division Street
City,State,and ZIP Code City,State,and ZIP Code
K4aohey. |N47G54
Country Country
USA
for certain deductions.Identify all of those that apply:
YES NO Cowomom YES NO oomo|T|om
�� El 1.VVi||this prupe�ybu the buye� �� �l �o�rimaq/ �� �� ' Homestead
�J �� residence? E] FX� 4.Solar Energy Heating or Cooling System
2. Does the buyer have a homestead tobevacated [:] FX� 5,Wind Power Device
for this residence? |f yes, provide address: �� 6.Hydroelectric Power Device
Address(number and street) El Z T. Geothermal Energy Heating or Cooling Device
City,State,ZIP code,and County %-?~o -�`�-��zc)�_{}'J'D- 0z a - 00?_ .
Under penalties pr perjury,|hereby certify that this Sales Disclosure,tp the best p,mx knowledge and belief,is true,correct and complete