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Homestead_Wiggs 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 conveyance documen MSJ Enterprises LLC, an Indiana limited liability company .: Address(number and street) Address (number and street) '� ' 3312 Aspen Drive (04,40 (-) .' City, State and ZIP Code City, State and ZIP Code Evansville, IN 47711 , Country Country United States of America Email Address Telephone Number Email Address Telephone Number 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 Seller Signature of Seller Printed Name of Seller Date signed (mm/dd/yyyy) Printed Name of Seller Date signed (mm/dd/yyyy) John Albers, Manager 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 Fol✓e�ance o ufan Wi Samantha Jill Owen a Address (number and street) Address (number and street) 211 S Seminary Street 211 S Seminary Street NOV 13 2023 City, State and ZIP Code City, State and ZIP Code Princeton, IN 47670 Princeton, IN 47670 `�_ �� Country Country GIBSON CteLOUNTY AUD2 l United States of America United States of America Email Address 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 Y -NO- CONDITION 0 0 1. Will this property be the buyer's primary residence? 0 3_ Homestead 0 0 4. Solar Energy Heating or Cooling System 0 0 2. Does the buyer have a homestead to be vacated for 0 p 5. Wind Power Device this residence? If yes, provide address: 0 El 6. Hydroelectric Power Device Address (number and street) 0 21 7. Geothermal Energy Heating or Cooling Device City, State,ZIP code, and county /2(a _ / - 1 /04 - 000. S »-oD 7 Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true,correct and complete