Homestead_Allen 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 e document
Hopper Homes& Electrical Contracting LLC, an Indiana limited
liability company
Address(number and street) Address (number and street) 4
814 N West Dr.
Rey
City, State and ZIP Code City, State and ZIP Cod . 10I4
Oakland City, IN 47660 _ , e
Country Country CO Q /
United States of America N4 1
qU
"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.
Sir i'f e r • Signature of Seller
Prin ame of Seller ` Date signed(mm/dd/yyyy) Printed Name of Seller Date signed (mm/dd/yyyy)
Mark Hopper, President 4/19/2024
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
Robert Allen Sasha Allen
Address(number and street) Address (number and street) , t
ti
317 SE 7th St. 317 SE 7th St. h a
} �
City, State and ZIP Code City, State and ZIP Code
Washington, IN 47501 Washington, IN 47501
Country Country
United States of America United States of America
YES NO CONDITION YES NO CONDITION
0 ❑ 1. Will this property be the buyer's primary residence? El ❑ 3. Homestead
❑ El 4. Solar Energy Heating or Cooling System
0 0 2. Does the buyer have a homestead to be vacated for ❑ 0 5. Wind Power Device
this residence? If yes, provide address:
❑ 0 6. Hydroelectric Power Device
Address(number and street) ❑ El 7. Geothermal Energy Heating or Cooling Device
City, State,ZIP code, and county 2/ - 14 - oO 1 • 102-0 0 ry
'
Under penalties of perjury, I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct and complete