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Homestead_Clark (4) 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., ^veyance document
Brandon L. Deputy
Address(number and street) Address(number and street)
11105 E Lincoln Heights Rd 144
City, State and ZIP Code City, State and ZIP Code Z/eC
Oakland City, IN 47660 ap
/f
Country Country c/ c„. 4z
04
United States of America
04,
Email Address
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Under penalties of perjury,I hereby certify this Sales Disclosure,to the best of my knowledge and belief,is true,corn nd 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 o ransferred real property,or
omits or falsifies any information required to be provided,commits a Level 5 felony.
\ ignature of Seller d, Signature of Seller
Printed Name of Seller Date Signed (mm/dd/ Printed Name of Seller Date Signed(mm/dd/yyyy)
Brandon L. Deputy yyyy)
12/3/2024
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
Hallie J.Clark
Address(number and street) Address (number and street)
422 W Trusler St
City, State and ZIP Code City, State and ZIP Code
Oakland City, IN 47660
Country Country
United States of America
Pursuant to IC 6-1.1-12-44,the Sales Disclosure Form may be used to apply for certain deductions.Identify all of those to }
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YES NO CONDITION YES NO CONDITION -" K<<...
sy ,
El4)„..
❑ 1. Will this property be the buyer's primary residence? El ❑ 3. Homestead ,
0 72. Does the buyer have a homestead to be vacated for 0 El 4. Solar Energy Heating or Cooling S tern
this residence? If yes, provide address: 0 El 5. Wind Power Device
0 El 6. Hydroelectric Power Device
Address(number and street)
0 © 7. Geothermal Energy Heating or Cooling Device
City, State,and ZIP Code County a(' -13_I 1 _ 0, —O 0 0. 5 L13 —
O C
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
information,SSN/Driver's License/ID/Other Number is necessary if a Homestead Deduction is being filed.)
3