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Homestead_Mizeur
• Docusign Envelope ID:1DOFFFD7-2FB7-481E-B536-7AB5EE02BE1F H. PREPARER Preparer of the Sales Disclosure Form Title Jeannie M. Kiesel Director Company Address(number and street,city,state,country,and ZIP Code) 221 NW Fifth Street (PO Box 1507, 47706), Evansville, IN 47708 I. SELLERS)/GRANTOR(S) Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document Braunson T. Mizeur Address(number and street) Address(number and street) 495 S 550 E City,state,and ZIP Code City,slate,and ZIP Code Francisco, IN 47649 Country Country USA E-mail 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 6-1.15.5.A person who knowingly and Intentionally falsifies the value of transferred �sianproperty,or omits or falsifies any information required to be provided,commits a Level 5 felony. Signature o�ller Signature of Seller `"--IVrihig NS a of Seiler 1rate,$)Arle 14mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy) 13ra�v►s�� I. Y�l�zeur [/�/CV `+ J. BUYER(S)IGRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTI,," AT APPLY Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on r.nvey c ocum;,.t Braunson T.Mizeur and Lexy K Godwin,joint tenants with full rights of survivorship Address(number and street) Address(number and street)495 S 550 E Dee City,slate,and ZIP Code City,slate,and ZIP Co e 0 - �01/. Francisco, IN 47649 7 Country Country G/eS USA O E-mail address apply for certain deductions.Identify all of tI , at apply: YES NO CONDITION YES NO CONDITION 1.Will this property be the buyer's primary D 0 3.Homestead O O residence? 0 © 4.Solar Energy Heating or Cooling System 2.Does the buyer have a homestead to be vacated 0 D 5,Wind Power Device O O for this residence?If provide yes, address: O D 6.Hydroelectric Power Device Address(number and street) 0 D 7.Geothermal Energy Heating or Cooling Device City,state,ZIP code,and county Z-12 12-Lroo -©00,2-17-u0�{ 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 tobe provided,commits a Level 5 felony.(Note:Both spouse's Page 3 of 5