Homestead_Hunt (21) H. PREPARER
Preparer of the Sales Disclosure Form Title
Matthew Jarvis Escrow Officer
Company E-mail address Telephone number
Southwestern Indiana Land Title matt@swinland.com (812)425-0055
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 ears on conveyance document
Chad D. Cundiff T
Address (number and street) Address(number an tr )
1827 N. SR 257 ��!!�
City, State
t and ZIP Code City, State and ZIP CockiG 3 j 2p�3
Otwell,
47564
Country Country >32,e-c �(� -
United States of America G/BSO r,OU
Email Address Telephone Number Email Address g Ud/T d Telephone Number
X(f ) 1jcL/- O
OR
Under penalties of perjury, I 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 of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.
)(Signature of r Signature of Seller
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed (mm/dd/yyyy)
Chad D. Cundiff 8/28/2023
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
Angela D. Hunt
Address (number and street}) ' Address (number and street)
kS r,Are. ( rid !fi t
City, State and ZIP Code City, State and ZIP Code
Country Country
United States of America
Email Address *Tgl i ne0Nymber Email Address Telephone Number
11
11
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:
YES NO CONDITION YES NO CONDITION
0 0 1. Will this property be the buyer's primary residence? El 0 3. Homestead
0 El 4. Solar Energy Heating or Cooling System
0 El 2. Does the buyer have a homestead to be vacated for 0 El 5. Wind Power Device
this residence? If yes, provide address:
0 El 6. Hydroelectric Power Device
Address (number and street) ❑ RI 7. Geothermal Energy Heating or Cooling Device
City, State, ZIP code, and county
Flo — _� - 103—OQ H -Qc .8
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.)
_ig.4. are of Bu r 1 pi
Signature of Buyer 2/Spouse
Printed Le.:111
Name of Buyer 1 Sign Date(MM/DD/YY) Printed Legal Name of Buyer 2/Spouse Sign Date(MM/DD/YY)
Angela D. Hunt 8/28/2023
Last 5 Di its of Buyer 1 SSN/Driver's License/ID/Other Number Last 5 Digits of Buyer 2/Spo �T. e 's License/ID/Other Number
xSSN: siyg TAIL a�. 37a.3y
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