Homestead_Ingler (2) f's
1. PREPARER
_
Preparer of the Sales Disclosure Form Title
Haley Smith _ - Escrow Officer
Company
Address(number and street,city,state,country,and ZIP Code)
7321 Eagle Crest Blvd., Suite A Evansville, IN 47715
I. SELLER(S)/GRANTOR(S)
Seller 1—Name as it appears on conveyance document Seller 2—Name as appears on conveyance document
Jason Daniel Schmitt
Address(number and street) Address(number and street)
ell rio c I, - L./ ,e,._..- tO r -
City,state,aid-ZIP Cage City,state,and ZIP Code
IIii,5 lea,4— i .--. /1/ LI lc,-3ct
Country Country
E-2i7,4 Tele hone number E-mail address Telephone number
( )
Underienalties 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-fh accordance with IC 6-1.1-5.5.A person who knowingly and intentionally falsifies the value of transferred
real property,orprrfils or falsifies any information required to be provided,commits a Level 5 felony.
Si n , of Seiir_ -, .. .____,__ Signature of Seller
P wiled- me Cf Seiler-- Date signed(mm/dd/yyyy) Printed Name of Seller Date signed(mm/dd/yyyy)
Jason Daniel Schmitt 7/27/2021
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS—ID T - • iii
Buyer 1—Neale as it appears on conveyance document Buyer 2—Name as it appearsr oFrly ce d ab-e MY
Bryan tngler
Address(number arid street) Address(number and street)
218 N Race St JUL 2 9 2,02i
City,state,and ZIP Code City,state,and ZIP Code
Haubstadt, IN 47639 .
,Toil
Country Country
GIBSON COUNTN rsuLy
US
E-mail address Telephone number E-mail address Telephone number
bainglet@gmail:com
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 YES NO CONDITION
/I 1 I 1.Will this property be the buyer's primary ril 0 3. Homestead
I residence?
1
pi 4.Solar Energy Heating or Cooling System
1 1 2. Does the buyer have a homestead to be vacated ri iv I 5.Wind Power Device
I—I for this residence? If yes, provide address: 1 1 1 I 6. Hydroelectric Power Device
Address(number and streeiti
I 11.1 7.Geothermal Energy Heating or Cooling Device
1I/' -
City,state,and ZIP Code County
1-1,-% i.,LI ex i cA at-t --r A, Li 9039 .,, t12- ( Ct l
Last 5 of SSN:
Page 3