Homestead_Meeks (2) 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 cony nce document
Shawn M. Gibson
Address(number and street) Address (number and street)
2106 S Boulevard PI .1-4,4>"),
City, State and ZIP Code City, State and ZIP Code C.
Princeton, IN 47670 ��
Country Country QjesO� 1Q?� )
United States of America
QO.--
Address (i G-, p
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief, is true, corm-t'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 We value of transferred
real property,or omits or falsifies any information required to be provided, commits a Level 5 felony.
Signat of Seller M, Signature of Seller
Printed Name of Seller Date signed (mm/dd/yyyy) Printed Name of Seller Date signed (mm/dd/yyyy)
Shawn M Gibson 12/6/2023
J. BUYER(S)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT APPLY
Buye - me as it appears on conveyance document Buyer 2-Name as it appeartict yanUbc t
Dicey D. Meeks 1 1
Address(number and street) Address(number and street)
2789 N SR 65, Unit 65 DEC 08 2023
City, State and ZIP Code City, State and ZIP Code
Patoka, IN 47666
Count '""fie a ''
Country Country
GIBSON COUNTY <-,,, ,,;jK
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
El ❑ 1. Will this property be the buyer's primary residence? ^ El 0 3. Homestead
❑ El 4. Solar Energy Heating or Cooling System
0 El 2. Does the buyer have a homestead to be vacated for ❑ El 5. Wind Power Device
this residence? If yes, provide address:
❑ El 6. Hydroelectric Power Device
Address(number and street) 0 El 7. Geothermal Energy Heating or Cooling Device
City, State.ZIP code, and county
0,26 - / - / - 3oY- nao. 988 -0.'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
I