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Homestead_Barclay H. PREPARER Preparer of the Sales Disclosure Form Title Jamie E.Smith Escrow Officer Company Address(number and street, city,state,country,and ZIP Code) 101 Plaza East Boulevard, Suite 102, Evansville, IN 47715 I. SELLERS)/GRANTOR(S) Seller 1 -Name as it appears on conveyance document Seller 2-Name as appears on cony a cument Southern Indiana Home Investments, LLC Address(number and street) Address(number and street) 2416 Shannon Street -4 .11 City,State,and ZIP Code City,State,and ZIP Code .40 Washington, IN 47501 2© Country Country 2025C''/eS E-mail Addy )ss ,, of my knowledge and belief,Is true{ nd complete as requir d by I w,anfl is prepared in accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifie Om value of transferred real ope iiiI E.,o Its or falsifies any Information required to be provided,commits a Level 5 felony. Sign tur r Signature of Seller • ;._. nt Name of Seller Date Signed(mrn/dd/yyyy) Printed Name of Seller Date Signed(mm/dd/yyyy) An ony Lengacher,Member July 3, 2025 July 3, 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 Phillip Dale Barclay Tina Michelle Barclay Address(number and street) Address(number and street) 111 North Jackson Street 111 North Jackson Street City,State,and ZIP Code City,State,and ZIP Code Oakland City, IN 47660-1521 Oakland City, IN 47660-1521 Country Country YES NO CONDITION YES NO CONDITION /424 1.Will this property be the buyer's primary CEr El 3.Homestead l_ ❑ residence? ❑ 4.Solar Energy Heating or Cooling System ED eks2.Does the buyer have a homestead to be vacated EliM, 5.Wind Power Device or this residence? If yes,provide address: ❑ ,R 6.Hydroelectric Power Device Address(number and street) ❑ 7.Geothermal Energy Heating or Cooling Device City,State,ZIP code,and County C�r -`L - I rS-'- o_ 000 . Li IS-004 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 3V '