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Homestead_Hall (17)
H. PREPARER Preparer of the Sales Disclosure Form Title Abbigail 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 conveyance document Michael L. Workman Carrie Workman Address(number and street) Address(number and street) 917 N Main St. 917 N Main St. City,State and ZIP Code City,State and ZIP Code Princeton, IN 47670 Princeton, IN 47670 Country Country United States of America United States of America Email Address 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 6-1.1-5.5.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. )4Cature of Seller /J -Snatu yl SglletC-7- Printed Name eller Date Signed(mm/dd/yyyy) Printed ame of Seller Date Signed(mm/dd/yyyy) Michael L. orkman • 8/8/2025 Carrie Workman 8/8/2025 J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL THAT LI ik on conveyance document Buyer 2—Name as it appears �- : t Buyer 1 Name as it appears y on conve Jennifer Hall Address(number and street) Address(number and street) AUG 1 3 2025 301 N. 10th St.,Apt. 17 City, State and ZIP Code City,State and ZIP Co ,r. Princeton, IN 47670 C/RSON COUCf Country Country fv.ry pl o United States of America NO CONDITION k ❑ 1. Will this property be the buyer's primary residence? L I ❑ 3. Homestead 0 4Y 2. Does the buyer have a homestead to be vacated for this ❑ © 4. Solar Energy Heating or Cooling System residence? If yes,provide address: 0 0 5. Wind Power Device Address(number and street) ❑ © 6. Hydroelectric Power Device ❑ © 7. Geothermal Energy Heating or Cooling Device City,State,and ZIP Code County a() 1 2 _06-3otA_dno • gib - 2 ' 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 Last 5 Digits of Buyer 2/Spouse SSN/Driver's License/Ief ther Number Page 3