Homestead_Smith (48) •
H. PREPARER
Preparer of the Sales Disclosure Form Title
Christa D.Tracey Escrow Officer
Company
Address(number and street, city, state, country, and ZIP code)
605 SE Martin Luther King Jr Boulevard, Evansville IN United States of America 47713 T
I. SELLER(S)/GRANTOR(S) r ■
Seller 1 -Name as it appears on conveyance document Seller 2-Name as it appears o on djj <yy�ir� �DrrD
Michael Gayso Marcia Gayso
Address(number and street) Address(number and street) MAR 21 an
5632 W SR 64 5632 W SR 64
City, State and ZIP Code City, State and ZIP Code CO Y AUDITOR
Princeton, IN 47670 Princeton, IN 47670 GIBSON
Country Country
United States of America United States of America
E-mail address
who knowingly and intentionally falsifies the value of transferred
real property,or omits or falsifies any information required to be provided,commits aeLevel)5 fel y.
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_ Date signed(mm/dd/yyyy) Printed Name of eller Date signe (mm/dd/yyyy)
Pnnte a -so �Se er g Marcia Gayso oa/44 AOa.v1
Micha ayso 03�(1/aoaa
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
Elyssa Marie Smith Tyler Jacob Mason
Address(number and street) Address (number and street)
829 S. Main St. 829 S. Main St.
GO PY
City, State and ZIP Code City, State and ZIP Code
Princeton, IN 47670 Princeton, IN 47670
Country Country
United States of America United States of America
c.,1
certain deductions. Identify all of those that a
9:2. YES NO CONDITION YES NO CONDITION
❑ 1. Will this property be the buyer's primary residence? 0 3. Homestead
8 ❑ Solar Energy Heating or Cooling System
I ❑ 2. Does the buyer have a homestead to be vacated for ❑ Wind Power Device
e-J this residence? If yes, provide address: ❑ Hydroelectric Power Device
Address(number and street) ❑ Geothermal Energy Heating or Cooling Device
1SIK 8a9 S /!?ab'r S*
City, State,ZIP code, and county L1 OO _�r-�Ci, 1Q l' O'Z`
` [Clan/ �7/ `(76170 6;6soh o�G-\1- QLF Vv v
N_ Perin e n�
Under penalties 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
transferred real property,or omits or falsifies any information required to be provided,commits a Level 5 felony.(Note:Both spouse's
information, SSN/Driver's License/ID/Other Number is necessary if a Homestead Deduction is being filed.)
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