Homestead_Goheen 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 con ce document
Weber Home Rentals, Inc., an Indiana corporation
1:4
Address(number and street) Address(number and street)
5521 S. 550 E
City, State and ZIP Code City, State and ZIP Code se/O
Francisco, IN 47649
Country Country GjeS r„j7
v l
United States of America O,y
Email Address
Under penalties of perjury, I hereby certify this Sales Disclosure,to the best of my knowledge and belief, is true,corr@4 and complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowinellird intentionally falsifies the value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
Signature of Seller Signature of
Printed Name of Seller Date sig ed(m /dd/yyyy) Printed Name Date signed(mm/dd/yyyy)
George F. Weber, 08 as ace3
J. BUYER(S)/GRANTEE(S)-APPLICATION FO 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
Caleb M. Goheen
Address(number and street) Address (number and street)
603 S Prince St
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670
Country Country
United States of America
used to apply for certain deductions. Identify all of those that apply:
7NO CONDITION YES/ NO CONDITION
0 1. Will this property be the buyer's primary residence? �0 0 3. Homestead
� / CI �4. Solar Energy Heating or Cooling System
0 W 2. Does the buyer have a homestead to be vacated for ❑ �5. Wind Power Device
this residence? If yes, provide address:
❑ r122. Hydroelectric Power Device
Address(number and street) 0 Mr 7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county %12, —3 `Q � - ���-,! _ 02—g .
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