HomeMy WebLinkAboutHomestead_Schmitt (11) H. PREPARER
Preparer of the Sates Disclosure Form Title
Megan Bogor Escrow Officer
Company
Address(number and street,city,state,country,and ZIP Code) • .
7412 Eagle Crest Blvd EvansvIlle, IN 47715
I.SELLER(S)/GRANTOR(S)
Seller 1—Name as It appears on conveyance document Seller 2—Name as appears on tr
Karen M.Cyphers Testamentary Trust
Address(number and street) Address(number and street)
101 1..) . Cec S,
City,state,anti ZIP Code ei - City..state,and ZIP Code APR 2 I ZOZ2
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-let_ rc,—CJ/'/\ ��/ 4-7(04-7F`
Country Country ,/�
US US ,/taa�rY1���LLLalllrr�k Y Av0'� t
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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 an nformotion required to be provided,commits a Level S felony.
SI nature eller �t Signature of Seller
t. J
rl d Name S ler D ens gnat crtmm/ddryyyy) Printed Name of Seller Date signed(mrntddlyyyy)
K y W. ramer Ty stee 04/14/2022
J. BUYER(S)/ORANTEE(S)-APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALL.THAT APPLY
Buyer I-Name as It appears on conveyance document Buyer 2—Name as It appears on conveyance document
Sandra S.Schmitt David E.Schmitt
' Address(mmtberand street) Address(number and street)
9774 South 450 West 9774 South 450 West
City,state,and ZIP Code _ City-state,and ZIP Code
Cynthiana,IN 47612 Cynthlana, IN 47612
Country Country
1.Will this property be the buyer's primary O 0 3.Homestead
residence? 0 p 4.Solar Energy Heating or Cooling System
nt 4.'Doos the buyer have a homestead to be vacated 0 O 6.Wind Power Device
41 for this residence?If yes,provide address: 0 p 6.Hydroelectric Power Device
lsfdres , un)byr jr qt) 0 C) 7.Geothermal Energy Heating or Cooling Device
ut,
lty.a ate.zipcodq,and county r 1
0,,Y1-1'n (,X)6► ) 1 1\. ("l tp_i .�
Und r penalties of perjury,I hereby certify that this Sales Disclosure,to the best of lay knowledge and belief,le true,correct and complete
i 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
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