Homestead_Viernes H. PREPARER
Preparer of the Sales Disclosure Form Title
Kris Coon Closing Agent
Company
Address(number and street,city,state,country,and.ZIP Code)
4600 Washington Ave., Suite 102, Evansville, IN 47714
I.SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyancument
Zheng Properties LLC
res n OM....` Address(number and street) �K4 u ,
,,sta IP Cod ,L\ 4, vi, City,state,and ZIP Code N /
1Y�� � I` /l 1)
Country Country J
USA USA -. 1,014
of my knowledge and belief,Qs t and complete as
required by law,and is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally fals rue of transferred
real property,or omits or falsifies any information required to be provided,commits a Level 5 felony. /T
Signature of Seller I + e Signature of Seller 04,
Printed Name of Seller te,si ne4(mm/, dd/vyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Dale Zheng, member 1 1 fl ja�a,4�
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
Tricia Mae Viernes Jojit Roque
Address(number and street) Address(number and street)
513 W Emerson St 513 W Emerson St
City,state,and ZIP Code City,state,and ZIP Code
Princeton IN 47670 Princeton IN 47670
Country Country
USA USA
1.Will this property be the buyer's primary () 0 3.Homestead
residence? 0 0 4.Solar Energy Heating or Cooling System
V2.Does the buyer have a homestead to be vacated 0 O 5.Wind Power Device
for this residence?If yes,provide address: 0 0 6.Hydroelectric Power Device
Address(number and street) 0 O 7.Geothermal Energy Heating or Cooling Device
City,state,ZIP code,and county R '\)—` 0
1 01 -0 O I . 319 'O
2-3
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
Page 3 of 5 a, —