Homestead_Medlen 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
Matthew L. Syfert Shannon E. Syfert
Address(number and street) Address (number and street)
301 E Olive Drive 301 E Olive Drive
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670 Princeton, IN 47670
Country Country
United States of America United States of America
Email Address
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
ignature of Seller r
eirl if NIP
Printed Name of Seller ate signed (mm/dd/yyyy) Printed Name of Se ler tg n. e .• i mm/dd/yyyy)
Matthew L. Syfert 2/29/2024 Shannon E. Syfert 2/29/2024
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAj4I?L1Y1 202ll
Buyer 1 —Name as it appears on conveyance document Buyer 2— Name as it appears on conveyance documer (�
Taylor Medlen Dalen Hale \\
Address (number and street) Address(number and street) 7 ez a
7826 S Ruppel Road 6006 W SR 64 GIBSON COUNTY AUDITOR
City, State and ZIP Code City, State and ZIP Code
Vincennes, IN 47591 Princeton, IN 47670
Country Country
United States of America United States of America
rt Email Address
apply for certain deductions. Identify all of those that apply:
)-+- YES NO CONDITION YES NO CONDITION
0 El ❑ 1. Will this property be the buyer's primary residence? RI 0 3. Homestead
❑ El 4. Solar Energy Heating or Cooling System
0 ❑ 2. Does the buyer have a homestead to be vacated for ❑ RI 5. Wind Power Device
this residence? If yes, provide address:
0 El 6. Hydroelectric Power Device
8 Address(number and street)
0 6a�6 c�. s R� 61 0 El7. Geothermal Energy Heating or Coolin e
g City, State, ZIP code, and county
1-- Prl ntG deM1, TN 1767P Gibson 26-a-(g-vw3 -001 2\1-Q 23
C°
Q Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief, is true,correct and complete
k 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
that apply. OR
YES NO CONDITION YES 6. Transaction includes multiple Sales Disclosure Forms
❑ 0 1. Sheriff Sale or Tax Sale 0 IZI SDF Form of
❑ RI 2. Short Sale 7. Date
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