Homestead_Tucker H. PREPARER
Preparer of the Sales Disclosure Form Title
Stacy Brown _ Settlement Agent - _ -_-
Company
Address(number and street.city.state.country.and ZIP Code)
2301 N.Burkhardt Road,Evansville,IN 47715
I. SELLERS)/GRANTOR(S)
Seller 1-Name as it appears on conveyance document
Seller 2-Name as appears on conveyance document
I Ron Smith Nancy Smith
Address(number and street)
Address(number and street)
ri s r 51 i%--t 5
City,state.and ZIP Code 1 City,state.and Zt
Co
- R/tk011 Lii;k%.I 1 C 11213�
l Country Country
h US US
E-mail address
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_
Itla re of belle Signature\of SellerDate si ned /dd/yyyy) Printed Name of Seller ( I Data signed(mmtdd/yyyy)
ted Name of Sr 9 (mm 04/22/2022
Ron Smith 04/22/2022 I. Nancy Smith
J. BUYER(S)/GRANTEE(S)—APPLICATION FOR PROPERTY TAX DEDUCTIONS-IDENTIFY ALFILED
THAT APPLY
Buyer 1-Name as it appears on conveyance document Buyer 2-Name as it appears on conveyancedocument
Kira Tucker
Address(number and street) Address(numberand street)
i 19J S g City,state.and ZIP Code City.state,and ZIP Code APR 2 5 2022
Country Country tthz.ejterd &, l/kiy.6. a-
US GIBBON COtINTYnu AUDITORber
I ( )
for in deduS NO is Identify all of those that apply:
i yES NO CONDITION
1.Will this property be the buyer's primary
0 3_Homestead
eliC
Q residence? 0 Gg 4_Solar Energy Heating or Cooling System
2.Does the buyer have a homestead to be vacated
0 GB 5.Wind Power Device
0 for this residence?If yes,provide address: 0 a 6.Hydroelectric Power Device
Address(number and street) 0 ® 7.Geothermal Energy Heating or Cooling Device
City,state.ZIP code,and county a6^ -Q S - 14 O\ -'00 O. -t 2-F—O O 1
•