Homestead_Stevens (9) H. PREPARER
1
Preparer of the Sales Disclosure Form - Title
Angela J. Moers 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 Name as it appears on cony yance document Seller 2—Name as it appears on conveyance document
Weichert force Mobility, Inc.
Address(number a1td street) Address(number and street)
120 Longwater Drive, S ' 1.Q6, Norwell, MA 02061
City, State and ZIP de City, State and ZIP Code
Norwell, MA 02 1 -��
Country '-� Country
United tes of America
E-m ' address • Telephone nurli b,er E-mail address 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 required to be provided,commits a Level 5 felony.
Signature of Seller Signature of Seller
Printed Name of Seller Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—IDENTIFY ALL T ' a
Buyer 1 —Name as it appears on conveyance document Buyer 2—Name as it appears or nvi dgn �
Brit W. Stevens Keela M. Stevens
Address(number and street) Address (number and street) MAR 8 2021
1946 S 50 E 1946 S 50 E
City, State and ZIP Code City, State and ZIP Code _ %%� ,1/�Princeton, IN 47670 Princeton, IN 47670 GISSON COUNT
Country Country Y AUD
rUnited States of America
YE NO CONDITION YES/ NO CONDITION
f ❑ 1. Will this property be the buyer's primary residence? Q' 0 3. Homestead
S
0 2. Does the buyer have a homestead to be vacated for ❑ 13/4. Solar Energy Heating or Cooling System
p/ 5. Wind Power Device
-' this residence? If yes, provide address:
Ad ress(number and street
0 0/6. Hydroelectric Power Device
6 , j�(n � 0 fa 7. Geothermal Energy Heating or Cooling Device
I�t�, State, an��ZIP Code County
I11-4FM U T /dU L 71P7b CO 26--121 c-3 oo-O o2 811 s-O23-