Homestead_Hensley (7) -
1 H. PREPARER
I
— - -- -- —
I Preparer of the Sales Disclosure Form Title
1Jamie E. Smith _ Escrow Officer
r Company •
Address(number and street.city state country,and ZIP Code
101 Plaza East Boulevard. Suite 102, Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller?-Name as appear_ ?n con.eyance document
{XIU LAN LIN DA XIANG ZHENG
Address(number and street) Address fnumber and scree*
302 N 10th Street 302 N 10th Street
City.State,and ZIP Code City.State and ZIP Code
Princeton, IN 47670-1 1 3 0 Princeton, IN 47670-1130
Country Country .
E-mail Address
bestct 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 S felony.
Signature ofiSell5r } ignature of Seller
k l G� ,,_
' inted Name of Seller T Date Signed(mn'adlyyyy) Pnnted Name '• gate:IA-ed(mm dd yyyy
jLIN October 20, 2023 DA XIANG ZHENG �( Oc ,• 20,2023
XIU LAN ( �
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J. BUYERS)/GRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDESFY ALL • •
441)
i Buyer 1-Name as it appears on conveyance document Buyer 2 Name as It ap::ea' nn
HOLLAND E. HENSLEY ... .__ 2Q?3
Address number a
Address(number and street) W�s,
2005 Boulevard Place — 'v
i —_----------- City,State and ZIP Cod,- GD�Q—
City,State,and ZIP CodeNj-,
•
Princeton •
, IN 47670-3445 - 40�/T
Country Country 0i4
E-mail Address
for certain deductions.Identify all of those that apply:
YES NO CONDITION YES/ NO CONDITION
1.Will this property be the buyer's primary r p 3. Homestead
LTV ❑ ES residence? E] ' 4.Solar Energy Heating or Cooling System
s the buyer have a homestead to be vacated 0 5.Wind Power Device
❑ for this residence? if yes,provide address 0 Er .Hydroelectric Power Device
Address(number and street) ❑ LO 7.Geothermal Energy Heating or Cooling Device
i
City.State.ZIP code.and County , -1Z l D-3 n(l -Oo0 06 1 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
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