Homestead_Johnson (6) HcPREPARER . :
- ---- - ----
Preparer of the Sales Disclosure Form
Title
Sherri Hudson Settlement Agent
Company Email Address
Address(number and street,city,state,country,and ZIP Code)
2301 N.Burkhardt Road,Evansville, IN 47715
I SELLER(S)/GRANTOR(S) -
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Samuel J.Steiner
Address(number and street) Address(number and stree�TL L1
131 Shadow Ct.SW jj��� 1 , ,
City.State,and ZIP Code City,State,and ZIP Code LL11
Huntsville,AL 35824
Country Country SEP 2 1 2023
US
Email Address
best of mknowledge
and babel;t� ,' lfatprfd'compiete: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 Seller Signature of Seller
6y
Printed Name of Seller Date Signed(mm/ddiyyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Samuel J.Steiner 09/15/2023 09/15/2023
J. BUYER(S)/GRANTEE(:S) APPLICATION FOR PROPERTY TAX'DEDUCTIONS,—IDENTIFY ALL THAT APPLY
1 Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document
Keaton Johnson
Address(number and street) Address(number and street)
5757 W.550 S.
City,State,and ZIP Code City,State,and ZIP Code
Owensville,IN 47665
Country Country
US
certain deductidns.Identify all of those that:apply:
YES NO CONDITION NO CONDITION
1.Will this property be the buyer's primary 0 3.Homestead
residence? 0 ® 4.Solar Energy Heating or Cooling System
0 2.Does the buyer have a homestead to be vacated 0 ® 5.Wind Power Device
for this residence?If yes,provide address: 0 (2 6.Hydroelectric Power Device
Address(number and street) (Q ® 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County 2,l._ 0-002 .co