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Homestead_Hoover 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 appear jc�onveyance document Amanda M. Cox J Address (number and street) Address(number and street) - 925 N. Polk St. City, State and ZIP Code City, State and ZIP Code JO `���Jll Oakland City, IN 47660 t7 7 �n?3 Country Country United States of America C'/8S H J�E-mail address address ��CO(� Telephone number Under penalties of perjury, I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is trut;rtorrect 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. )S'�gn:tu�la� r, Signature of Seller Pri teti Name of Seller 4 Date signed(mmtddtyyyy) Printed Name of Seller Date signed(mm/dd/yyyy) Amanda M. Cox 6/28/2023 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 William D. Hoover Address (number and street) Address(number and street) 925 N Polk Dr. City, State and ZIP Code City, State and ZIP Code Oakland City, IN 47660 Country Country United States of America E-mail address for certain deductions.Identify all of those that apply: YES NO CONDITION YES NO CONDITION p ❑ 1. Will this property be the buyer's primary residence? © 0 3. Homestead ❑ © 4. Solar Energy Heating or Cooling System 0 '!ef 2. Does the buyer have a homestead to be vacated for ❑ p 5. Wind Power Device this residence? If yes, provide address: ❑ El 6. Hydroelectric Power Device Address (number and street) 0 © 7. Geothermal Energy Heating or Cooling Device City, State,ZIP code, and county '-}I 1,, - `, O, i✓y1_O+° - 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