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Homestead_King (5) H. PREPARER 1 Preparer of the Sales Disclosure Form Title Kris Coon Closing Agent Company I Address (number and street, city, state, country, and ZIP Code) 4600 Washington Ave., Suite 102, Evansville, IN 47714 I. SELLERS)/GRANTOR(S) Seller 1 -Name as it appears on conveyance document 1 Seller 2- Name as appears on conveya - r 'ent Christopher Marsh res numbe nd slreti) ' Address (number and street) 4A 0d ;tate, andlIP Co City, state, and ZIP Code 84 VKC-t-W tVI\1 Country Count USA USA Country Q�e60 4.2,N, of my knowledge and belief, is i t and complete� � as required by law, and is prepared in accordance with IC 6-1.1-5.5. A person who knowingly and intentionally fal ' * .'.1 ue of transferred real property, or omits or falsifies any in4formation required to be provided, commits a Level 5 felony. Signs of Sel /77, /�1/ Signature of Seller L �4� P led Name eller Date signed (mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy) Christopher Marsh C/F/,?/2 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 Jesika Anne Nicole King Address (number and street) Address (number and street) 715 South Seminary Street City, state, and ZIP Code City, state, and ZIP Code Princeton, IN 47670 Country Country for certain deductions. Identify all of those that apply: YES NO CONDITION YES NO CONDITION O O 1. Will this property be the buyer's primary O O 3. Homestead residence? 0 O 4. Solar Energy Heating or Cooling System O i0 2. Does the buyer have a homestead to be vacated 0 O 5. Wind Power Device for this residence? If yes, provide address: O O 6. Hydroelectric Power Device Address (number and street) 0 p 7. Geothermal Energy Heating or Cooling Device City, state, ZIP code, and county 6 - 2-07_ 1-103-0 01 . 5q e — v 2-"3 I Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, Is true, correct and complete C't Page 3 of 5 ,