Homestead_Fortner 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
Michael P. Weaver Maria A.Weaver
Address(number and street) Address (number and street)
4177 E Valley Pass 4177 E Valley Pass
City, State and ZIP Code City, State and ZIP Code
Haubstadt, IN 47639 Haubstadt, IN 47639
Country Country
United States of America United States of America
Email Address
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.
$ignatur S er O� l(Signa e of Seller ,
x � -�t 1
Printed Name of Seller "v l� Date signed(mm/dd/yyyy) Pri ted ame of Sell —4 ' t igned (mm/dd/yyyy)
Michael P. Weaver 12/22/2023 Maria A. Weaver 2 2/20
E -APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL THAT A LY �ll
J. BUYER(S)/GRANTEE(S) (pp/pp J ,
Buyer 1 -Name as it appears on conveyance document Buyer 2-Name as it appears on convejcedocument
Nicole M. Fortner Gary K. Fortner •Y 282s
Address(number and street) Address(number and street'/9SON
520 N 8th St 520 N 8th St On
City, State and ZIP Code City, State and ZIP Code N�-q
Vincennes, IN 47591 Vincennes, IN 47591 efO/
Country Country
United States of America 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
ICJ 0 1. Will this property be the buyer's primary residence? 2 0 3. Homestead r''`N
❑ 0 4. Solar Energy Heating or Co_ inq ':'em
IZ ❑ 2. Does the buyer have a homestead to be vacated for ❑ El 5. Wind Power Device `"4 ,,
josp
this residence? If yes, provide address:
0 2 6. Hydroelectric Power Device
Address(number and street) 0 2 7. Geothermal Energy Heating or Cooling Devi
520 N 8th St City, State,ZIP code, and county 2_ --23 -`I_�0 _00Z . 43g,c2-1, ,
Vincennes, IN 47591 Knox
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