Homestead_Denbo 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 document
Cameron W. Benson P1-
Address(number and street) Address(number and street)
2915 S 850 E
City, State and ZIP Code City, State and ZIP Code E
Oakland City, IN 47660 410k
Country Country ?? ?Q?3
United States of America
Email Address
my knowledge and belief, is true,orl ' : •: omplete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the va of transferred
real proper or omits or falsifies any information required to be provided,commits a Level 5 felony.
Sign e Q Seller ../ Signature of Seller
.-
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed (mm/dd/yyyy)
Cameron W. Benson 11/8/2023
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
Quinn Michael Denbo
Address(number and street) Address(number and street)
505 S. Main St.
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670
Country Country
United States of America
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 1. Will this property be the buyer's primary residence? 0 0 3. Homestead
❑ 0 4. Solar Energy Heating or Cooling System
0 0 2. Does the buyer have a homestead to be vacated for ❑ p 5. Wind Power Device
this residence? If yes, provide address:
❑ 0 6. Hydroelectric Power Device
Address (number and street) 0 El 7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county
06—(3 - - 7OO . 7` 0 -o0'1
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