Homestead_Schmitt (28) . -
H. PREPARER
Preparer of the Sales Disclosure Form Title
Kayla Vauahn Title Aaent
Company
Address(number and street,city,state,country,and ZIP Code)
17 W. Main Street Posevville. IN 47633
I. SELLER(S)/GRANTOR(S)
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Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
David A. Emerson Paula M. Epperson
Address(number and street) Address(number and street)
201 S.6th Ave 201 S.6th Ave
City,state,and ZIP Code City,state,and ZIP Code
Haubstadt, IN 47639 Haubstadt. IN 47639
Country Country
E-mail address
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,commit,a a Level felony.
natureS2 o $eler;ir ,-"'7 S#,nature o Seller I
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Printed e Date signed(mm/cld/yyyy) Feted Name of Stale Date signed(mm/dd/yyyy)
David A. Epperson 12/13/2021 Paula M. Epperson 12/13/2021
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
Timothy J.Schmitt Donna S. Schmitt
Address(number and street) Address(number and street)
9701 Lockwood Road 9701 Lockwood Road
City,state,and ZIP Code City,state,and ZIP Code
Posevville. IN 47633 Posevville. IN 47633
Country Country
E-mail 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 apely:
YES NO CONDITION YES NO CONDITION CA
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0 0 1.Will this property be the buyer's primary 0 El 3. Homestead Cb
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residence? 0 0 4.Solar Energy Heating or Cooling Sy8. c-3
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2. Does the buyer have a homestead to be vacated CI El 5.Wind Power Device =f ca
E3 ID for this residence? If yes,provide address: ED El 6. Hydroelectric Power Device ::-i<.;N t.;•±1 1
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Address(number and spreet) 0 0 7. Geothermal Energy Heating or Cool ice IMP
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c•,,state,and ZIP Code ,__..-- -' County 26-19-31-400-000.705-009 (--,
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Un er pa hies 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