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Homestead_Smith (84)
H. PREPARER Preparer of the Sates Disclosure/y� g Form \\pt ' Title 1 T )� y_rLil, ILO A)rG� //fit / / 0-C� Company . Address(number and street.city,state.country,and ZIP Code) 7820 Eagle Crest Blvd,Suite 201,Evansville,IN 47715 I. SELLER(S)IGRANTOR(S) Seller 1-Name as it appears an conveyance document Seller 2-Name as appears on conveyance document Willard R.Hazel and Janice J.Hazel,as Co-Trustees of the Joint Revoi _ Address(number and street) Address(number and street) 1120 N Main Street (-re Al—i City,state,and ZIP Code City,state,and ZIP Code v- Princeton,IN 47670 Country Country US E-mail address 5� - ( ) 5a_vK e.. i 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 • mils a Level 5 felony. Signalure of Seller S0 ure of Sc r • Printed Name of Sella Date signed(mm/dd/yyyy) , led Name rller Date signed(mm/ddlyyyy) Willard Hazel, 02/04/2022 r&V1tL 1J L±&- -<.-) 02/04/2022 _� J. BUYER(S)IJGRANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDE T cF - • .. a as it appears on conveyance document Buyer 2-Name as it appears oranglyaga i Uriah B.Smith Kyle M.Larson ..ress • • rut street) Address(number and street) FEB 0 7 2022 ' 7150 Oak Park Dr "� SI-1Z_-26'"U12-©2-Ll,000- 7150 Oak ParkDr /�_ , City, ��state,and ZIP Code '-City.stale,and ZIP Code I„L C�. 1iYaz y «✓. ' Newburgh,IN 47630 Newburgh,IN 47630 Country Country GIg30N COUNTY AUDITOR US US ti.9 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: tJ YES NO CONDITION YES NO CONDITION 'rY1 'I.Will this property be the buyers primary ,. 3.Homestead y'V Q residence? 0 0' 4.Solar Energy Heating or Cooling System C i ( y 0 0- 5.Wind Power Device O 2.Does the buyer have a homestead to be vacated p,, for this residence? if yes,provide address: ❑ J 6.Hydroeleclric Power Device t Address(number and street:) 0 7.Geothermal Energy Heating or Cooling Device `= t 603 S. --a. — if St bak Pa.s-k (�vlt�City,Slate,and ZIP Code County AI- 06 -3 o z- o v . 8 3 3 —oL . Page 3