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Homestead_Goodwin 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 appe r o c eyance document Anthony Mlynarczyk Address(number and street) Address(number and street) 1) 215 S Main St. ✓O City,State and ZIP Code City, State and Z - Code 01 Oakland City, IN 47660 cO?s United tates of America Country Country Qi�,SO�CO0� tidy . Email 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 pre•ared 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 falsifie li y inform- ',n required to be provided,commits a Level 5 felony. ,,Signature of Se -r Signature of Seller 40 Printed Name of S- - I .. Date Signed(mm/dd/ Printed Name of Seller Date Signed(mm/dd/yyyy) Anthony Mlynar.- yyyy) I 7/1/2025 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 Timothy Goodwin Address(number and street) Address(number and street) 8291 W. Base Rd. City,State and ZIP Code City, State and ZIP Code Richland, IN 47634 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 that apply: YES NO CONDITION YES NO CONDITION El 0 1. Will this property be the buyer's primary residence? © 0 3. Homestead 0 Id 2. Does the buyer have a homestead to be vacated for 0 El 4. Solar Energy Heating or Cooling System this residence? If yes, provide.address: 0 El 5. Wind Power Device Address(number and street) 0 El 6. Hydroelectric Power Device 0 El 7. Geothermal Energy Heating or Cooling Device City, State,and ZIP Code County ` i -141- I'S -1o4-- ©oo .--1s- col- 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 Page 3