Homestead_Bailey H. PREPARER
AP ewer of the..galosiDisclosup Form Title
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Reglona Title Services LLC Title Company
Comp
Address(number and street,city,state,country,and ZIP Code)
7820 Eagle Crest Blvd,Suite 201,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
Kelly J.Runau ,
Address(number and street) Address(number and street) aoltanv ',Irmo°NOSOID
219 W Washington Street _ r'f"'"'P9.2191' 77 771.274-#4
City,state,and ZIP Code City,state,and ZIP Code
Oakland City,IN 47660 ZZOZ T. Z NV1
Country Country '
US ,
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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 I w,and Is prepared in accord rice with IC 6-1.1-5.5.A person who knowingly and Intentionally falsifies the value of transferred
real propert ,or olpfte or falsifi nformation required to be provided,commits a Level 5 felony. .
Signature of a el? Signature of Seller
- - -
Printed e Seller Data signed(mm/dd/yyyy) Printed Name of Seller r Date signed(mmlddlyyyy)
Kelly J.Runau 01/21/2022 L_ 01/21/2022
J. BUYER(S)IGRANTEE(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
Devon W.Bailey Chelsey D.Bryan
Address(number and street) Address(number and street)
220 E.Garfield Ave 220 E.Garfield Ave
City,state,and ZIP Code City,state,and ZIP Code
Princeton,IN 47670 Princeton,IN 47670
. . ..
Country Country
US US
E-mail address
, _
YES NO CONDITION YES NO CONDITION
1.Will this property be the buyer's primary ® 0 3.Homestead
0) 0 residence? 0 (Z4 4.Solar Energy Heating or Cooling System
, X 2.Does the buyer have a homestead to be vacated 0 ® 5.Wind Power Device
0 for this residence?if yes,provide address: 0 (XI S.Hydroelectric Power pevice
Address(number and street) 0 (E) 7. Geothermal Energy Heating or Cooling Device
City,state,and ZIP Code County
. 10— 14-1R —30) -00 0_ 9-5-1-001— _
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