Homestead_Mercer (2) H. PREPARER
Preparer of the Sales Disclosure Form.) • Title
Title Company
Company
Address(number and street,city,state, country,and ZIP Code)
7820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1 —Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Ryan Henrich
Addressss(number and street) Address(number and street) i-
403 E Walnut Street
City,State,and ZIP Code City,State,and ZIP Code
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Fort Branch,IN 47648 S4).)
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Country Country 4),9
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eSON 2 ( )
Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and ):4_ correct,and complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally4 value of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. ' /70,9
nature of S.Ileriv_A, Signature of Seller
Printed Name of Seller Date Signed(mm/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy)
Ryan Henrich 09/17/2024 09/17/2024
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
Griffin Mercer
Address(number and street) Address(number and street)
101 N Polk Street
City,State,and ZIP Code City,State,and ZIP Code
Fort Branch,IN 47648
Country Country
US
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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 YE NO CONDITION
1.Will this property be the buyer's primary )611 0 3.Homestead
residence? 0 0 4.Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated 0 0 5.Wind Power Device
•
for this residence? If yes,provide address: 0 0 6.Hydroelectric Power Device
Address(number and street) 0 ® 7. Geothermal Energy Heating or Cooling Device
City,State,and ZIP Code County
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