Homestead_Smith (47) H. PREPARER
Preparer of the Sales Disclosure Form Title
Kelly Norton Escrow Officer
Company
Address(number and street,city,state,country,and ZIP Code)
101 Plaza East Boulevard, Suite 102, Evansville, IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document Seller 2-Name as appears on conveyance document
AMY N. BANET MICHAEL S. STEADMAN
Address(number and street) Address(number and street)
79 N Spore Dr 79 N Spore Dr
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670-8973 Princeton, IN 47670-8973
Country Country
E-mail address
Under penalties of perjury,I hereby certify this Sales isclosure,t 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.
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Name er
Dat sig ed(mm/dd/yyyy) inted Name of Seller Date signed(mm/dd/yyyy)
AMY N.BANET December 10, 2021 MICHAEL S.STEADMAN December 10, 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
ERIC C. SMITH NIKI L. STIVERS
Address(number and street) Address(number and street)
79 N Spore Dr 79 N Spore Dr
City,state,and ZIP Code City,state,and ZIP Code
Princeton, IN 47670-8973 Princeton, IN 47670-8973
Country
Country
YES NO CONDITION Irr NO CONDITION G7
1.Will this property be the buyer's primary
0 3.Homestead Ea
11110
I r idence? 4.Solar Energy Heating or Cooling Sy co
C)
X
a
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2.Does the buyer have a homestead to be vacated ❑ �l
�{ 5.Wind Power Device o
r c., HI
for this residence?If yes, provide address:It aQ 0 6.Hydroelectric Power Device l"
vri
to
Address(number and street) El7.Geothermal Energy Heating or Coolo evi0ee d
City,state,and ZIP Code County 26-12-09-103-003.833-027 0
n
Under penalties of perjury,I hereby certify that this Sales Disclosure,to the best of my knowledge and belief,is true,correct arl8 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