Loading...
Homestead_Mattingly H. PREPARER Preparer of the Sales Disclosure Form Title Christina Gourley Title Clerk Company Address(number and street,city,state,country,and ZIP Code) 4600 Washington Ave, Suite 102, Evansville, IN 47714 I. SELLER(S)/GRANTOR(S) Seller 1—Name as it appears on conveyance document Seller 2—Name as appears William CodyDeHart on conveyance document Stacey L. DeHart Address(number and street) _e,inns n er an strut) City,state,and ZIP Code C,linyec,�state,and ZIP Code Country Country I r/) C� E-mail ad Telephone number 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,commit -Level 5 felony. 'gnature of Se *,_-----7 ,o„ of Seller Printed Name of Seller Date signed(mm/dd/yyyy) Prin Name f Seller Date signed(mm/dd/yyyy) William Cody DeHart �7�.,`" 4rE)',...zai_� Stacey L. D Hart J. BUYER(S)/GRANTEE(S)-APPLICA736N FOR PROPERTY TAX DEDUC ONS-IDENTIFY ALL THAT APPLY Buyer 1—Name as it appears on conveyance document Buyer 2—Name as it appears on conveyance document MaryJane Marie Mattingly Randall Grant Becht Xddresss`(number d s�ttreeeet))/} �'^ 5 Add (number and re ) FILED city,state.and ZIP Code City,state,and ZIP Code v Y/' , t-IN --1771i7 44 6 J U N 1 4 20�22 ;ountry r h � Country yVtHTd apply for in deductions.Identify all of those that apply: YES O CONDITION YES NO CONDITION O 1.Will this property be the buyer's primary O 3.Homestead residence? 0 O 4.Solar Energy Heating or Cooling System O ,2. Does the buyer have a homestead to be vacated O O 5.Wind Power Device for this residence?If yes,provide address: O O 6.Hydroelectric Power Device Address(number and street) 0 C) 7.Geothermal Energy Heating or Cooling Device City,state,ZIP code,and county .,V)-\I-‘3 -Lk LA-oot . 143- c 6 Page 3 of 5 i