Homestead_Owens (9) H. PREPARER
Preparer of the Sales Disclosure Form Title
• Stacey Salzman Settlement Agent
Company
Address(number and street,city,state,country,and ZIP Code)
2301 N.Burkhardt Road,Evansville, IN 47715
I.SELtER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyan o�u n
Stephen D.Johnson
Address(number and st t
) t Address(number and street) .
502 E.Zimmerman D i7 �-�Cki(Vis ITjr • /yo,/ .�
City,State,and ZIP Code City,State,and ZIP Code i
Princeton,IN 47670 a1 D ke ` `�1�� / r �02,i _
Country ' 9 u Country 0/esUS ON
--0'
Co Q
Email Address
a•and belief,is true,correct,an �ompiete 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.nature of :f r Signature of Seller
1. / - -----
'rinted Name of Seller � Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mrn/dd/yyyy)
Stephen D.Johnson 10/25/2023 10/25/2023
J. QUYER(S)/GRANTEE(S) -APPLICATION FOR PROPERTY TAX:DEDUCTIONS-IDENNTIF`Y ALL THAT APPLY •
Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document
Gina Owens Bret Harrell
Address(number and street) Address(number and street)
City,State,and ZIP Code City,State,and ZIP Code
•
Country Country
US US
( )
Pursuantto IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of thosethatapply:
YES NO CONDITION YES NO CONDITION •
® 1.Will this property be the buyer's primary ® 0 3. Homestead •
residence? Q ® 4.Solar Energy Heating or Cooling System a
® 2. Does the buyer have a homestead to be vacated 0 ® 5.Wind Power Device
for this residence?If yes,provide address: O ® 6. Hydroelectric Power Device
Address(number and street) 0 IX 7.Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County
2�-12 -06^ Za3-oo1 _30_ - L)2— ,
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
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