Homestead_Clark (8) 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
Evelyn J. Owens by Ronald E. Owens, her attorney-in-fact
Address(number and street) Address(number and street)
8275 Ontario Kane
pjp-I„i
City, State and ZIP Code City, State and ZIP Code t
Indianapolis, IN 46268 ,
ii
Country Country
United States of America `d �� 4'3.,
Gfeg�, -�� • �1/4
Under penalties of perjury, I hereby certify this Sales Disclosure,to the best of my knowledge and belief, isi /,hyo n�con lete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. R
Signature of Sell r r Signature of Seller
av,,,./ , L4e-W a,..,,ate_i, ly----..1:--
Printed Na a of S ler I Date Signed (mm/dd/ Printed Name of Seller Date Signed(mm/dd/yyyy)
Evelyn J. Owens by Ronald E. Owens, her YYYY)
attorney-in-fact 7/19/2024
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 conveyceiocument
Gary W. Clark Kimberly J. Clark
Address (number and street) Address(number and street) ,I ,{#'~,M
1614 Brentwood Dr. 1614 Brentwood Dr. 1
s
City, State and ZIP Code City, State and ZIP Code Or
Princeton, IN 47670 Princeton,,IN 47670
Country Country
United States of America United States of America
U Email Address
Y) YES NO CONDITION YES NO CONDITION
J El ❑ 1. Will this property be the buyer's primary residence? El 0 3. Homestead
'D 0 El 4. Solar Energy Heating or Cooling System
0 ❑ 0 2. Does the buyer have a homestead to be vacated for 0 El 5. Wind Power Device
Y this residence? If yes, provide address:
0 0 6. Hydroelectric Power Device
5 Address(number and street) 0 El 7. Geothermal Energy Heating or Cooling Device
1614 Brentwood Dr.
:o
0 City, State, and ZIP Code County
I Princeton, IN 47670 Gibson -2—V1_—®� _ La_ ion- 001. 4-7 C{ ®��
7 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
transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. (Note:Both spouse's