Homestead_Price (3) 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 appears on conveyance document
Bryce Jutzi
Address (number and street) Address (number and street)
11242 E 50 S
City, State and ZIP Code City, State and ZIP Code
Oakland City, IN 47660
Country Country
United States of America
Email Address Telephone Number Email Address i Telephone Number
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 re uired to be provided, commits a Level 5 felony.
Signature of Seller nI cc Signature of Seller
PtaPrinted Name of Seller Date ed (mm/dd/ Printed Name of Seller Date Signed (mm/dd/yyyy)
Bryce Jutzi yyyy)
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 a s co e e document
Katlyn Price
Address (number and street) Address (number and st et) 51-
City, State and ZIP Code City. State and ZIP Code
, INS Country?-J- , L‘ -1 �v
Countryt
apt
United States of America ' it' GOv
o
Email Address (
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 I YES NO CONDITION4.,*#
O 1. Will this property be the buyer's primary residence? 0 O 3. Homestead
2. Does the buyer have a homestead to be vacated for o Ei 4. Solar Energy Heating or Cooling Sysfeni
this residence? If yes, provide address: O El 5. Wind Power Device
Address (number and street) C RI 6. Hydroelectric Power Device
O RI 7. Geothermal Energy Heating or Cooling Device
City, State, and ZIP Code County
-1-3 - �- - \--jco- Dc \ . VQ: _ - Q
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
'