Homestead_Morton (3) H. PREPARER
Preparer of the Sales Disclosure Farm I Title
Leah Brown Closer
Company
Address (number and street, city, state, country, and ZIP Code)
7820 Eagle Crest Blvd., Suite 201 - Evansville, IN 47715
I. SELLERS)/GRANTORS)
Seller 1 — Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Jessica L (Swatzell) Keown Shannon N. 13egeman.
[Address (number and street) Address (number and street)
5000 Sweetser Ave _ 916 S. E. 6th Street
City, state, and ZIP Code i City, state, and ZIP Code
1 Evansville, IN 47715 Evansville,IN T_
Country Country
US US
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.
Signature of Seller Signature of Seller
Se e P\ A-0,(AN-661Ec, 1
Printed Name of Seller Date signed (mm/dd/yyyy) Printed Name of Seller ' Date signed (mmfdd/yyyy)
J. BUYER(S)/GRANTEE(S) - APPLICATION FOR PROPERTY TAX DEDUCTIONS - !DENT Y ALL THAT APPLY
r - —
u er 1 — Name s Wt ars n , r.veyance document Buyer 2 - Name as it appears on currents° gun a
Add s number and tre )O _ f Address (number and street)-1 S - --6 D
City state, and ZIP Code City, state, and ZIP Code BAN
Country I Country
certain deductions. Identify all of thos Na1rappty:
YES NO CONDITION YES NO CONDITION
1. Will this property be the buyer's primary ❑ E] 3. Homestead
0 � residence? ❑ [ 4. Solar Energy Heating or Cooling System
a 2. Does the buyer have a homestead to be vacated ❑ ❑ 5. Wind Power Device
for this residence? If yes, provide address: 0 E 6. Hydroelectric Power Device
Address number and street) El 0 7. Geothermal Energy Heating or Cooling Device
975S230W
City, state, ZIP code, and county — 2[ -1 ' _ 1"-� _ 2 Q0 _OW • ( 2 —o j
Princeton, IN 47670 v t o l J \
Under penalties of perjury, I hereby certify that this Sales Disclosure, to the best of my knowledge and belief, is true, correct and complete
�/ Last5ofSSN
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